Healthcare Provider Details

I. General information

NPI: 1831507409
Provider Name (Legal Business Name): TWIN RIVERS URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2014
Last Update Date: 07/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W LEOTA ST
NORTH PLATTE NE
69101-6293
US

IV. Provider business mailing address

720 N WEBB
GRAND ISLAND NE
68803-6293
US

V. Phone/Fax

Practice location:
  • Phone: 308-534-2900
  • Fax:
Mailing address:
  • Phone: 308-384-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRYAN NOKELBY
Title or Position: CEO
Credential: M.D.
Phone: 308-534-2900