Provider Demographics
NPI:1366236564
Name:INTEGRATIVE HEALTH M.D.
Entity type:Organization
Organization Name:INTEGRATIVE HEALTH M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO FOUNDER; CMO.
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CRONSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-C
Authorized Official - Phone:402-681-8866
Mailing Address - Street 1:601 N 108TH CIR STE 145
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-1701
Mailing Address - Country:US
Mailing Address - Phone:402-681-8866
Mailing Address - Fax:
Practice Address - Street 1:601 N 108TH CIR STE 145
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-1701
Practice Address - Country:US
Practice Address - Phone:402-681-8866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty