Healthcare Provider Details

I. General information

NPI: 1447335500
Provider Name (Legal Business Name): JOANNE E BRONSON CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S 70TH ST STE 200
LINCOLN NE
68510-2452
US

IV. Provider business mailing address

301 S 70TH ST STE 200
LINCOLN NE
68510-2452
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-7641
  • Fax: 402-483-0527
Mailing address:
  • Phone: 402-483-7641
  • Fax: 402-483-0527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number120002
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: