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General NPI Number Information
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NPI Number | 1780808667
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Entity Type | Organization
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Legal Business Name | DOCTORS OF CHILDREN, LINCOLN PC
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 6041 VILLAGE DR STE 150
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City | LINCOLN
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State | NE
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Zip | 68516-5774
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Country | US
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Telephone | 402-423-2739
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Fax | 402-423-5991
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Provider Business Mailing Address
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Address Line | 6041 VILLAGE DR STE 150
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City | LINCOLN
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State | NE
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Zip | 68516-5774
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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 | PRACTICE ADMINISTRATOR
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Name | AMY BRYAN
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Credential |
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Telephone | 402-423-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 17210
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 22488
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License Number State | NE
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