| NPI | 1568501302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE M BRUGGER Administrator 402-887-4151 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2022-11-18 |