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General NPI Number Information
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NPI Number | 1700078854
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Entity Type | Organization
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Legal Business Name | NORTHEAST NEBRASKA CARDIOLOGY CONSULTANTS P C
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | 109 N 29TH ST SUITE 1
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City | NORFOLK
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State | NE
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Zip | 68701-3261
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Country | US
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Telephone | 402-644-4411
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Fax | 402-644-4422
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Provider Business Mailing Address
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Address Line | 109 N 29TH ST SUITE 1
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City | NORFOLK
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State | NE
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Zip | 68701-3261
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Country | US
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Telephone | 402-644-4411
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Fax | 402-644-4422
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. THOMAS R. BRANDT
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Credential | M.D.
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Telephone | 402-644-4411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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