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General NPI Number Information
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NPI Number | 1548845894
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Entity Type | Organization
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Legal Business Name | DECK FAMILY PRACTICE
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 7111 A ST STE 201
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City | LINCOLN
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State | NE
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Zip | 68510-4283
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Country | US
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Telephone | 402-489-7100
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Fax | 402-489-3249
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Provider Business Mailing Address
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Address Line | 7111 A ST STE 201
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City | LINCOLN
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State | NE
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Zip | 68510-4283
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Country | US
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Telephone | 402-489-7100
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Fax | 402-489-3249
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Authorized Official
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Title or Position | MEDICAL PRACTICE ADMINISTRATOR
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Name | MS. CHRISTINA M HARLOW
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Credential |
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Telephone | 402-489-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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