Healthcare Provider Details

I. General information

NPI: 1538149414
Provider Name (Legal Business Name): LUKE T NORDQUIST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17607 GOLD PLZ
OMAHA NE
68130-5606
US

IV. Provider business mailing address

17607 GOLD PLZ
OMAHA NE
68130-5606
US

V. Phone/Fax

Practice location:
  • Phone: 402-991-8468
  • Fax: 402-991-8469
Mailing address:
  • Phone: 402-918-4688
  • Fax: 402-991-8469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number22733
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: