Healthcare Provider Details

I. General information

NPI: 1669420774
Provider Name (Legal Business Name): DARLA EISENHAUER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DARLA EISENHAUER-SPIRES MD

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S 48TH ST SUITE 508
LINCOLN NE
68506-1276
US

IV. Provider business mailing address

1500 S 48TH ST SUITE 508
LINCOLN NE
68506-1276
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-2886
  • Fax: 402-489-9684
Mailing address:
  • Phone: 402-483-2886
  • Fax: 402-489-9684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number24435
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: