Healthcare Provider Details

I. General information

NPI: 1366256497
Provider Name (Legal Business Name): RODNEY ISOM EMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ROD ISOM EMT

II. Dates (important events)

Enumeration Date: 02/07/2025
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 158
PAGE NE
68766-0158
US

IV. Provider business mailing address

50489 872ND RD
PAGE NE
68766-5505
US

V. Phone/Fax

Practice location:
  • Phone: 402-338-5901
  • Fax:
Mailing address:
  • Phone: 402-340-5473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number12621
License Number StateNE

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: