| NPI | 1467650085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDA TERRI KONKEN Ifp Coordinator 402-464-8866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NE 7409) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2020-08-22 |