Healthcare Provider Details

I. General information

NPI: 1013141076
Provider Name (Legal Business Name): SARA ELIZABETH HARGREAVES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 11/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S 48TH ST STE 400
LINCOLN NE
68506-1276
US

IV. Provider business mailing address

1600 SO 48TH ST STE 600
LINCOLN NE
68506-1274
US

V. Phone/Fax

Practice location:
  • Phone: 402-481-8500
  • Fax: 402-481-8501
Mailing address:
  • Phone: 402-483-3333
  • Fax: 402-483-3297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number29654
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: