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General NPI Number Information
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NPI Number | 1164670196
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Entity Type | Organization
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Legal Business Name | CREIGHTON UNIVERSITY MEDICAL CENTER
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 3802 RAYNOR PKWY STE 201
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City | BELLEVUE
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State | NE
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Zip | 68123-2528
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Country | US
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Telephone | 402-449-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 3802 RAYNOR PKWY STE 201
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City | BELLEVUE
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State | NE
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Zip | 68123-2528
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Country | US
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Telephone | 402-449-5800
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MS. BRIDGET R PLUMB
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Credential | DPT
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Telephone | 402-449-5800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2670
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License Number State | NE
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