Healthcare Provider Details

I. General information

NPI: 1710807169
Provider Name (Legal Business Name): PRAIRIE CREEK FAMILY MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1356 126TH RD
STROMSBURG NE
68666-6240
US

IV. Provider business mailing address

1356 126TH RD
STROMSBURG NE
68666-6240
US

V. Phone/Fax

Practice location:
  • Phone: 402-764-2491
  • Fax: 402-764-2491
Mailing address:
  • Phone: 402-764-2491
  • Fax: 402-764-2491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AARON PHILLIPS
Title or Position: CLINIC MANAGER
Credential:
Phone: 402-764-2491