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General NPI Number Information
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NPI Number | 1063164523
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Entity Type | Organization
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Legal Business Name | BOARD OF REGENTS, UNIVERSITY OF NEBRASKA
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 2510 11TH AVENUE, MSAB RM 184
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City | KEARNEY
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State | NE
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Zip | 68849
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Country | US
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Telephone | 308-865-8964
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Fax | 308-865-8218
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Provider Business Mailing Address
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Address Line | 2510 11TH AVENUE, MCAB 184
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City | KEARNEY
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State | NE
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Zip | 68849
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Country | US
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Telephone | 308-865-8218
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Fax | 308-865-8680
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Authorized Official
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Title or Position | VICE CHANCELLOR BUSINESS AND FINANC
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Name | JON WATTS
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Credential |
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Telephone | 308-865-8205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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