Healthcare Provider Details

I. General information

NPI: 1841036563
Provider Name (Legal Business Name): ALI J BARTELS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2024
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42ND AND EMILE ST
OMAHA NE
68198-0001
US

IV. Provider business mailing address

11523 GERTRUDE CT APT 306
LA VISTA NE
68128-7704
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-4000
  • Fax:
Mailing address:
  • Phone: 308-529-7529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: