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General NPI Number Information
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NPI Number | 1144035973
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Entity Type | Individual
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Provider Name | SHANE BUCK
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Gender | Male
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 3901 NORMAL BLVD
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City | LINCOLN
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State | NE
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Zip | 68506-5261
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Country | US
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Telephone | 402-435-1122
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Fax | 402-435-4854
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Provider Business Mailing Address
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Address Line | 4820 GREENWOOD ST
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City | LINCOLN
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State | NE
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Zip | 68504-2136
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Country | US
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Telephone | 308-340-2025
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 93119
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License Number State | NE
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