Healthcare Provider Details

I. General information

NPI: 1376337501
Provider Name (Legal Business Name): STEVEN THOMAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 CUSTER AVE
NORFOLK NE
68701-0859
US

IV. Provider business mailing address

802 CUSTER AVE
NORFOLK NE
68701-0859
US

V. Phone/Fax

Practice location:
  • Phone: 402-371-3567
  • Fax:
Mailing address:
  • Phone: 402-371-3567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: