Healthcare Provider Details

I. General information

NPI: 1104742634
Provider Name (Legal Business Name): RENEWED HEALTH OUTREACH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 VILLAGE DR STE B
LINCOLN NE
68516-5363
US

IV. Provider business mailing address

3510 VILLAGE DR STE B
LINCOLN NE
68516-5363
US

V. Phone/Fax

Practice location:
  • Phone: 402-937-1920
  • Fax: 402-739-8915
Mailing address:
  • Phone: 402-984-2281
  • Fax: 402-739-8915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JODI FUEHRER
Title or Position: NP-C/OWNER
Credential: APRN
Phone: 402-984-2281