Healthcare Provider Details

I. General information

NPI: 1891994273
Provider Name (Legal Business Name): AMBER BARGSTADT MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W NORFOLK AVE STE 201
NORFOLK NE
68701-5232
US

IV. Provider business mailing address

333 W NORFOLK AVE STE. 201
NORFOLK NE
68701-5232
US

V. Phone/Fax

Practice location:
  • Phone: 402-614-8444
  • Fax: 402-379-3933
Mailing address:
  • Phone: 402-379-2030
  • Fax: 402-379-3933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: