Healthcare Provider Details

I. General information

NPI: 1962366039
Provider Name (Legal Business Name): SAMANTHA LYNN DORCEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W 2ND ST STE 1
WAYNE NE
68787-1957
US

IV. Provider business mailing address

3140 E ELK LN STE 600
FREMONT NE
68025-8650
US

V. Phone/Fax

Practice location:
  • Phone: 531-519-6074
  • Fax: 531-519-6858
Mailing address:
  • Phone: 402-936-6198
  • Fax: 402-816-4402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number116547
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: