Basic Information
Provider Information | |||||||||
NPI: | 1770049702 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | SWEET DREAMS SLEEP SERVICES, P.C | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2855 10TH ST STE B | ||||||||
Address2: |   | ||||||||
City: | GERING | ||||||||
State: | NE | ||||||||
PostalCode: | 693412202 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4012413344 | ||||||||
FaxNumber: | 8884562467 | ||||||||
Practice Location | |||||||||
Address1: | 2855 10TH ST STE B | ||||||||
Address2: |   | ||||||||
City: | GERING | ||||||||
State: | NE | ||||||||
PostalCode: | 693412202 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3086333000 | ||||||||
FaxNumber: | 3086333001 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/14/2019 | ||||||||
LastUpdateDate: | 07/28/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | MEYER | ||||||||
AuthorizedOfficialFirstName: | BRITTANY | ||||||||
AuthorizedOfficialMiddleName: | J. | ||||||||
AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
AuthorizedOfficialTelephone: | 3082250687 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: | DR. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | M.D. | ||||||||
NPICertificationDate: | 07/28/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QS1201X |   |   | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | Sleep Medicine |
No ID Information.