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General NPI Number Information
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NPI Number | 1609580554
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Entity Type | Organization
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Legal Business Name | THE NEBRASKA MASONIC HOME
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Dates
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Enumeration Date | 01/05/2023
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 1300 AVENUE D
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City | PLATTSMOUTH
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State | NE
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Zip | 68048-1055
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Country | US
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Telephone | 402-296-7324
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Fax | 402-296-3855
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Provider Business Mailing Address
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Address Line | 1300 AVENUE D
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City | PLATTSMOUTH
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State | NE
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Zip | 68048-1055
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Country | US
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Telephone | 402-296-7324
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Fax | 402-296-3855
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. APRIL L JOHNSTON
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Credential | RN
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Telephone | 402-293-7303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SL0600X
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Taxonomy Name | Long-Term Care Clinical Nurse Specialist
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License Number |
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License Number State |
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