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General NPI Number Information
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NPI Number | 1790479418
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Entity Type | Organization
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Legal Business Name | ADVANCED MEDICAL IMAGING, LLC
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 7601 PIONEERS BLVD
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City | LINCOLN
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State | NE
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Zip | 68506-4675
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Country | US
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Telephone | 405-484-6667
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 82568
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City | LINCOLN
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State | NE
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Zip | 68501-2568
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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 | AO
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Name | KEVIN R GILLESPIE
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Credential |
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Telephone | 402-484-4845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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