| NPI | 1215066568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH JANKUSKI COO 402-343-4409 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-03-04 |
| Last Update Date | 2018-04-03 |