Healthcare Provider Details

I. General information

NPI: 1437406436
Provider Name (Legal Business Name): JOSHUA M OLMSTEAD BA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 N 30TH ST
OMAHA NE
68131-2136
US

IV. Provider business mailing address

555 N 30TH ST. BOYS TOWN NATIONAL RESEARCH HOSPITAL
OMAHA NE
68131-2136
US

V. Phone/Fax

Practice location:
  • Phone: 402-498-6693
  • Fax: 402-452-5015
Mailing address:
  • Phone: 402-498-6693
  • Fax: 402-452-5015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number900787
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number900787
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: