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General NPI Number Information
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NPI Number | 1043643547
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Entity Type | Organization
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Legal Business Name | ALEGENT CREIGHTON HEALTH
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Dates
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Enumeration Date | 08/20/2013
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 6901 N 72ND ST
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City | OMAHA
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State | NE
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Zip | 68122-1709
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Country | US
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Telephone | 402-572-2919
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 642117
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City | OMAHA
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State | NE
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Zip | 68164-8117
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EVERT KUIPER II
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Credential |
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Telephone | 402-343-4420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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