Healthcare Provider Details

I. General information

NPI: 1053967109
Provider Name (Legal Business Name): HUNT ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2019
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9829 S 168TH AVE STE F
OMAHA NE
68136-1147
US

IV. Provider business mailing address

9829 S 168TH AVE STE F
OMAHA NE
68136-1147
US

V. Phone/Fax

Practice location:
  • Phone: 402-502-9868
  • Fax: 402-502-9832
Mailing address:
  • Phone: 402-502-9868
  • Fax: 402-502-9832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BREANNE PFLANZ
Title or Position: NURSE PRACTITIONER
Credential: APRN
Phone: 402-502-9868