Healthcare Provider Details

I. General information

NPI: 1669078382
Provider Name (Legal Business Name): BHRT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 S 59TH ST
LINCOLN NE
68516-2306
US

IV. Provider business mailing address

5601 S 59TH ST
LINCOLN NE
68516-2306
US

V. Phone/Fax

Practice location:
  • Phone: 308-223-3559
  • Fax:
Mailing address:
  • Phone: 308-223-3559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LENA JONES
Title or Position: OFFICE MANAGER
Credential:
Phone: 402-850-0953