| NPI | 1306684295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JAMES BONHAM V.P Operations 402-681-4829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-07-16 |