Healthcare Provider Details

I. General information

NPI: 1205941069
Provider Name (Legal Business Name): SARAH VONDRAK GERNHART M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH VONDRAK HANSEN

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 03/27/2024
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 N. 190TH PLAZA SUITE 1200
OMAHA NE
68022
US

IV. Provider business mailing address

717 N. 190TH PLAZA SUITE 1200
OMAHA NE
68022
US

V. Phone/Fax

Practice location:
  • Phone: 402-815-1700
  • Fax: 402-815-1955
Mailing address:
  • Phone: 402-815-1700
  • Fax: 402-815-1955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number21299
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: