Healthcare Provider Details

I. General information

NPI: 1942509252
Provider Name (Legal Business Name): NATALIE TYMKOWYCH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2011
Last Update Date: 10/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E DECATUR ST
WEST POINT NE
68788-1566
US

IV. Provider business mailing address

500 E DECATUR ST
WEST POINT NE
68788-1566
US

V. Phone/Fax

Practice location:
  • Phone: 402-372-2477
  • Fax: 402-372-6770
Mailing address:
  • Phone: 402-372-2477
  • Fax: 402-372-6770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28150
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: