# FAMILY PRACTICE OF GRAND ISLAND P C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FAMILY PRACTICE OF GRAND ISLAND
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639123185
- **Authorized official:** STEVEN L HUSEN M.D. (OWNER)
- **Authorized official phone:** (308) 381-0162

## Contact information

- **Practice address:** 3563 PRAIRIEVIEW ST, STE 300, GRAND ISLAND, NE 68803-4442
- **Practice address phone:** (308) 381-0162
- **Practice address fax:** (308) 389-4445
- **Mailing address:** PO BOX 9802, GRAND ISLAND, NE 68802-9802
- **Mailing address phone:** (308) 381-0162
- **Mailing address fax:** (308) 389-4445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 05/20/2006
- **Last updated:** 11/29/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 28D0455757 | CLIA | NE |
| 05 | — | ========= | — | NE |