Healthcare Provider Details

I. General information

NPI: 1225463045
Provider Name (Legal Business Name): KAREN A CULBERTSON OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2013
Last Update Date: 09/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 S 171ST CT
OMAHA NE
68130-2394
US

IV. Provider business mailing address

2510 S 171ST CT
OMAHA NE
68130-2394
US

V. Phone/Fax

Practice location:
  • Phone: 402-330-3063
  • Fax: 402-334-4418
Mailing address:
  • Phone: 402-330-3063
  • Fax: 402-334-4418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number870
License Number StateNE

VIII. Authorized Official

Name: DR. KAREN A CULBERTSON
Title or Position: PRESIDENT
Credential: O.D.
Phone: 402-330-3063