Provider Demographics
NPI:1366943730
Name:CENTRAL NEBRASKA PEDIATRICS LLC
Entity type:Organization
Organization Name:CENTRAL NEBRASKA PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:COY
Authorized Official - Last Name:HASKETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-293-6622
Mailing Address - Street 1:5907 O AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-1529
Mailing Address - Country:US
Mailing Address - Phone:308-293-6622
Mailing Address - Fax:
Practice Address - Street 1:211 W 33RD ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-3484
Practice Address - Country:US
Practice Address - Phone:308-293-6622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty