| NPI | 1962610493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT D JANSEN Practice Administrator 402-327-6001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 103T00000X Psychologist |
| 2080A0000X Pediatrics, Adolescent Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2021-06-10 |