Healthcare Provider Details

I. General information

NPI: 1891721395
Provider Name (Legal Business Name): NEBRASKA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 05/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 DOUGLAS ST
OMAHA NE
68131-2705
US

IV. Provider business mailing address

4200 DOUGLAS ST
OMAHA NE
68131-2705
US

V. Phone/Fax

Practice location:
  • Phone: 402-552-3222
  • Fax: 402-552-2172
Mailing address:
  • Phone: 402-552-3222
  • Fax: 402-552-2172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. STEPHANIE DAUBERT
Title or Position: CFO
Credential:
Phone: 402-552-2889