Healthcare Provider Details

I. General information

NPI: 1760057087
Provider Name (Legal Business Name): DANAK TOTAL HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 05/20/2021
Certification Date: 05/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 A ST STE 201
LINCOLN NE
68510-4283
US

IV. Provider business mailing address

6831 SUMNER ST
LINCOLN NE
68506-1548
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-7100
  • Fax: 402-489-3249
Mailing address:
  • Phone: 402-525-1512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHY L. HAVLICEK
Title or Position: PRESIDENT
Credential: DNP, APRN-NP
Phone: 402-525-1512