Basic Information
| Provider Information | |||||||||
| NPI: | 1487069985 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOELLER | ||||||||
| FirstName: | BRITTANI | ||||||||
| MiddleName: | |||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 W 33RD ST | ||||||||
| Address2: | |||||||||
| City: | KEARNEY | ||||||||
| State: | NE | ||||||||
| PostalCode: | 688453484 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3088652141 | ||||||||
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| Practice Location | |||||||||
| Address1: | 211 W 33RD ST | ||||||||
| Address2: | |||||||||
| City: | KEARNEY | ||||||||
| State: | NE | ||||||||
| PostalCode: | 688453484 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3088652141 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2014 | ||||||||
| LastUpdateDate: | 08/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2014020089 | MO | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 1564 | NE | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.