Healthcare Provider Details

I. General information

NPI: 1376564260
Provider Name (Legal Business Name): BECKY MARLENE SAATHOFF P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 PINE LAKE RD SUITE 211
LINCOLN NE
68516-5497
US

IV. Provider business mailing address

5200 S 56TH ST STE 2
LINCOLN NE
68516-1884
US

V. Phone/Fax

Practice location:
  • Phone: 402-423-4200
  • Fax: 402-423-4201
Mailing address:
  • Phone: 402-421-6200
  • Fax: 402-421-6070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1266
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: