Healthcare Provider Details

I. General information

NPI: 1598639296
Provider Name (Legal Business Name): FRANCINE ELLEN BONTAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2025
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 N 102ND CT STE 200
OMAHA NE
68114-2194
US

IV. Provider business mailing address

PO BOX 3755
OMAHA NE
68103-0755
US

V. Phone/Fax

Practice location:
  • Phone: 402-354-9770
  • Fax: 402-354-9795
Mailing address:
  • Phone: 402-354-2100
  • Fax: 402-354-2155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number116192
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberH192652
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: