Healthcare Provider Details

I. General information

NPI: 1386880011
Provider Name (Legal Business Name): CARRIE ANN DELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2008
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 S 70TH ST STE 110
LINCOLN NE
68516-4282
US

IV. Provider business mailing address

4501 S 70TH ST STE 110
LINCOLN NE
68516-4282
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-3834
  • Fax: 402-489-5049
Mailing address:
  • Phone: 402-489-3834
  • Fax: 402-489-5049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2007015915
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: