Healthcare Provider Details

I. General information

NPI: 1376776294
Provider Name (Legal Business Name): WILLIAM LEONE EMT-P
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 08/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S VISITING EAGLE ST
NIOBRARA NE
68760-7201
US

IV. Provider business mailing address

110 S VISITING EAGLE ST
NIOBRARA NE
68760-7201
US

V. Phone/Fax

Practice location:
  • Phone: 402-857-2300
  • Fax: 402-857-2315
Mailing address:
  • Phone: 402-857-2300
  • Fax: 402-857-2315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number1445
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: