Individual
DR. BRENT JONATHAN TIERNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8303 DODGE ST, SUITE 300, OMAHA, NE 68114-4108
(402) 354-5250
(402) 354-3437
Mailing address
PO BOX 10190, VIRGINIA BEACH, VA 23450-0190
(800) 477-5240
(757) 463-6572
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
5627
NE
207VX0201X
Gynecologic Oncology Physician
Primary
27892
NE
207VX0201X
Gynecologic Oncology Physician
35.097164
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100250445-00
—
NE
05
—
100264208-00
—
NE
05
—
1033316294
—
IA
Enumeration date
06/29/2007
Last updated
11/05/2014
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