Basic Information
| Provider Information | |||||||||
| NPI: | 1285920678 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARTELS | ||||||||
| FirstName: | DANYEL | ||||||||
| MiddleName: | ALYSIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 360 N SADDLE CREEK RD | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681312230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4029706492 | ||||||||
| FaxNumber: | 4029706493 | ||||||||
| Practice Location | |||||||||
| Address1: | 360 N SADDLE CREEK RD | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681312230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4029706492 | ||||||||
| FaxNumber: | 4029706493 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2011 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 13924 | NE | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.