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General NPI Number Information
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NPI Number | 1346424017
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Entity Type | Organization
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Legal Business Name | MATERNAL FETAL MEDICINE ADVANCED FETAL IMAGING CENTER
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 575 S 70TH ST STE 405
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City | LINCOLN
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State | NE
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Zip | 68510-2471
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Country | US
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Telephone | 402-219-8005
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Fax | 402-219-8084
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Provider Business Mailing Address
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Address Line | 575 S 70TH ST STE 405
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City | LINCOLN
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State | NE
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Zip | 68510-2471
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Country | US
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Telephone | 402-219-8005
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Fax | 402-219-8084
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Authorized Official
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Title or Position | M.D.
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Name | SEAN PATRICK KENNEY
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Credential | M.D.
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Telephone | 402-219-8005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 19291
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License Number State | NE
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