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General NPI Number Information
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NPI Number | 1538189857
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Entity Type | Organization
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Legal Business Name | MIDWEST OB/GYN CLINIC, PC
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 1410 N 13TH ST
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City | NORFOLK
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State | NE
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Zip | 68701-2669
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Country | US
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Telephone | 402-379-2322
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 209
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City | NORFOLK
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State | NE
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Zip | 68702-0209
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BRENDA PROFFITT
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Credential |
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Telephone | 402-379-2322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | NE
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