Healthcare Provider Details

I. General information

NPI: 1437710043
Provider Name (Legal Business Name): CHILDREN'S PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 06/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 DODGE ST
OMAHA NE
68114-4113
US

IV. Provider business mailing address

PO BOX 247037
OMAHA NE
68124-7037
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-6935
  • Fax: 402-955-6931
Mailing address:
  • Phone: 402-955-6935
  • Fax: 402-955-6931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SARAH J STEVENS
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 402-955-6587