Healthcare Provider Details

I. General information

NPI: 1679483663
Provider Name (Legal Business Name): BROOK GANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 NW 1ST ST
LINCOLN NE
68521-4496
US

IV. Provider business mailing address

5001 NW 1ST ST
LINCOLN NE
68521-4496
US

V. Phone/Fax

Practice location:
  • Phone: 402-378-9169
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: