Healthcare Provider Details

I. General information

NPI: 1780895110
Provider Name (Legal Business Name): JOHNSON COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 HIGH STREET
TECUMSEH NE
68450
US

IV. Provider business mailing address

PO BOX 538
TECUMSEH NE
68450-0538
US

V. Phone/Fax

Practice location:
  • Phone: 402-335-3361
  • Fax: 402-335-6342
Mailing address:
  • Phone: 402-335-2811
  • Fax: 402-335-2826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARY JANE KENT
Title or Position: CEO
Credential:
Phone: 402-335-3361