Healthcare Provider Details

I. General information

NPI: 1871975128
Provider Name (Legal Business Name): CRISTA D FEW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS CRISTA DANAE NAZARIO

II. Dates (important events)

Enumeration Date: 06/23/2015
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 S 70TH ST STE 140
LINCOLN NE
68516-4276
US

IV. Provider business mailing address

PO BOX 860876
MINNEAPOLIS MN
55486-0876
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-3755
  • Fax: 402-483-3774
Mailing address:
  • Phone: 402-483-8590
  • Fax: 402-483-8599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11182
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number36310
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: