Healthcare Provider Details

I. General information

NPI: 1326838319
Provider Name (Legal Business Name): AUDREY SRB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 N 8TH ST STE 350
LINCOLN NE
68508-1429
US

IV. Provider business mailing address

151 N 8TH ST STE 350
LINCOLN NE
68508-1429
US

V. Phone/Fax

Practice location:
  • Phone: 531-500-3623
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: