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General NPI Number Information
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NPI Number | 1568501302
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Entity Type | Organization
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Legal Business Name | ANTELOPE MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 102 W 9TH ST
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City | NELIGH
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State | NE
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Zip | 68756-1114
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Country | US
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Telephone | 402-887-4151
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Fax | 402-887-4092
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Provider Business Mailing Address
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Address Line | PO BOX 109
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City | NELIGH
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State | NE
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Zip | 68756-0109
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Country | US
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Telephone | 402-887-5440
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Fax | 402-887-4564
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DIANE M BRUGGER
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Credential |
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Telephone | 402-887-4151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 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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