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General NPI Number Information
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NPI Number | 1336928159
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Entity Type | Organization
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Legal Business Name | SANTEE SIOUX TRIBE OF NEBRASKA
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Dates
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Enumeration Date | 09/22/2023
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Last Update Date | 09/22/2023
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Provider Practice Location Address
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Address Line | 110 S VISITING EAGLE ST
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City | NIOBRARA
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State | NE
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Zip | 68760-7201
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Country | US
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Telephone | 402-857-2300
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Fax | 402-857-2910
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Provider Business Mailing Address
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Address Line | 110 S VISITING EAGLE ST
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City | NIOBRARA
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State | NE
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Zip | 68760-7201
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Country | US
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Telephone | 402-857-2300
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Fax | 402-857-2910
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Authorized Official
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Title or Position | HEALTH SYSTEMS SPECIALIST
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Name | VIETTA K SWALLEY
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Credential |
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Telephone | 402-857-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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