| NPI | 1083725337 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | PATRICIA A RAFFERTY Billing Office Manager 402-554-1103  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 110063)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A051642)  | 
| Enumeration Date | 2006-08-31 | 
| Last Update Date | 2020-08-22 |