Healthcare Provider Details

I. General information

NPI: 1679409460
Provider Name (Legal Business Name): KLAYTON TODD NORDEEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 VALLEY RD STE 210
LINCOLN NE
68510-4892
US

IV. Provider business mailing address

4600 VALLEY RD STE 210
LINCOLN NE
68510-4892
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-5079
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10584
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: