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General NPI Number Information
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NPI Number | 1861497380
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Entity Type | Organization
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Legal Business Name | NORTHEAST NEBRASKA SURGERY CENTER LLC
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 2701 W NORFOLK AVE STE 101
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City | NORFOLK
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State | NE
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Zip | 68701-4408
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Country | US
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Telephone | 402-644-7262
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Fax | 402-644-7227
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Provider Business Mailing Address
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Address Line | 2701 W NORFOLK AVE STE 101
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City | NORFOLK
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State | NE
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Zip | 68701-4408
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Country | US
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Telephone | 402-644-7262
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Fax | 402-644-7227
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Authorized Official
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Title or Position | MEMBER OF BOARD OF MANAGERS
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Name | KELLY A. DRISCOLL
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Credential |
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Telephone | 402-644-7637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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