Healthcare Provider Details

I. General information

NPI: 1285683870
Provider Name (Legal Business Name): NEBRASKA ORTHOPAEDIC AND SPORTS MEDICINE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 S 70TH ST NEBRASKA ORTHOPAEDIC AND SPORTS MEDICINE P.C. SUITE 200
LINCOLN NE
68510-2471
US

IV. Provider business mailing address

575 S 70TH ST NEBRASKA ORTHOPAEDIC AND SPORTS MEDICINE P.C. SUITE 200
LINCOLN NE
68510-2471
US

V. Phone/Fax

Practice location:
  • Phone: 402-488-3322
  • Fax: 402-488-1172
Mailing address:
  • Phone: 402-488-3322
  • Fax: 402-488-1172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MELISSA IRENE BUESSING
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 402-488-3322