Healthcare Provider Details

I. General information

NPI: 1144101262
Provider Name (Legal Business Name): WILLOW BORGERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 VALLEY DR
WAYNE NE
68787-2277
US

IV. Provider business mailing address

801 E 4TH ST APT 334
WAYNE NE
68787-2258
US

V. Phone/Fax

Practice location:
  • Phone: 402-833-1080
  • Fax:
Mailing address:
  • Phone: 605-860-8984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: