Healthcare Provider Details

I. General information

NPI: 1215904131
Provider Name (Legal Business Name): NEBRASKA SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 S 70TH ST
LINCOLN NE
68506-1613
US

IV. Provider business mailing address

1730 S 70TH ST
LINCOLN NE
68506-1613
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-6600
  • Fax: 402-484-6610
Mailing address:
  • Phone: 402-484-6600
  • Fax: 402-484-6610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberASC017
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE MONHOLLON
Title or Position: CFO
Credential:
Phone: 402-484-9011