# JOSE GARY NADALA CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** JOSE GARY NADALA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548866064
- **Authorized official:** JENNIFER WITZKE-KONRADI (MANAGER)
- **Authorized official phone:** (402) 474-1511

## Contact information

- **Practice address:** 2222 S 16TH ST STE 410, LINCOLN, NE 68502-3785
- **Practice address phone:** (402) 474-1511
- **Practice address fax:** (402) 474-1611
- **Mailing address:** 2222 S 16TH ST STE 410, LINCOLN, NE 68502-3785
- **Mailing address phone:** (402) 474-1511
- **Mailing address fax:** (402) 474-1611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/09/2020
- **Last updated:** 06/22/2021