# PROACTIVE WOUND CARE NE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134943780
- **Authorized official:** DR. NATHAN PAYNE DPM (PRESIDENT)
- **Authorized official phone:** (801) 815-6500

## Contact information

- **Practice address:** 650 J ST STE 405, LINCOLN, NE 68508-2924
- **Practice address phone:** (801) 815-6500
- **Mailing address:** PO BOX 607, CENTERVILLE, UT 84014-0607
- **Mailing address phone:** (801) 815-6500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/11/2024
- **Last updated:** 11/11/2024