Healthcare Provider Details

I. General information

NPI: 1316381130
Provider Name (Legal Business Name): AMY C. GOLDING MACH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY C HARVEY

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 S 70TH ST STE 250
LINCOLN NE
68506-3693
US

IV. Provider business mailing address

2810 NEBRASKA ST
SIOUX CITY IA
51104-3633
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-4186
  • Fax: 402-489-5279
Mailing address:
  • Phone: 308-380-4897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberD129421
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number101279
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: