Basic Information
| Provider Information | |||||||||
| NPI: | 1316063894 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY OF NEBRASKA MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 S 54TH ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681323401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025530211 | ||||||||
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| Practice Location | |||||||||
| Address1: | 983280 NEBRASKA MEDICAL CTR | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681983280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025599917 | ||||||||
| FaxNumber: | 4025596749 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MEAD | ||||||||
| AuthorizedOfficialFirstName: | SHERRY | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | FAMILY NURSE PRACTITIONER | ||||||||
| AuthorizedOfficialTelephone: | 4025599917 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | APRN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 110265 | NE | Y | Hospitals | General Acute Care Hospital |
No ID Information.