Individual
AUSTIN ENFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P-C
Contact information
Practice address
8248 S 96TH ST, LA VISTA, NE 68128-3126
(402) 717-9500
Mailing address
12058 IVA ST, GRETNA, NE 68028-4656
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2858
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/30/2022
Last updated
01/30/2023
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