Healthcare Provider Details

I. General information

NPI: 1356444251
Provider Name (Legal Business Name): RHONDA S PURDY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 09/02/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7910 CASS ST
OMAHA NE
68114-3582
US

IV. Provider business mailing address

201 HILLSDALE DR # 44
TREYNOR IA
51575-4107
US

V. Phone/Fax

Practice location:
  • Phone: 402-991-0181
  • Fax: 402-964-2459
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number110493
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA058793
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: