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NPI 1073325411

NPI 1073325411 : GAGE RYAN EHLERS EMT : OMAHA, NE

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General NPI Number Information
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    NPI Number           |    1073325411
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    Entity Type          |    Individual 
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    Provider Name        |    GAGE RYAN EHLERS EMT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/22/2025
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    Last Update Date     |    01/22/2025
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Provider Practice Location Address
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    Address Line         |    2500 CALIFORNIA PLZ 
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    City                 |    OMAHA
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    State                |    NE
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    Zip                  |    68178-0002
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    Country              |    US
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    Telephone            |    402-280-2700
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    15905 PFLUG RD 
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    City                 |    SPRINGFIELD
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    State                |    NE
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    Zip                  |    68059-6912
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    Country              |    US
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    Telephone            |    402-429-9188
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    E3887283
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    License Number State |    NE
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