Organization
NEBRASKA NATIONAL GUARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA S KEECH RN (DEPUTY STATE SURGEON)
(402) 476-7944
Entity
Organization
Contact information
Practice address
2400 NW 24TH ST, LINCOLN, NE 68524-1892
(402) 309-1497
Mailing address
6905 WHITEWATER LN, LINCOLN, NE 68521-8998
(402) 476-7944
Taxonomy
Speciality
Code
Description
License number
State
261QM1102X
Military Outpatient Operational (Transportable) Component Clinic/Center
Primary
57319
NE
Other
Enumeration date
10/04/2006
Last updated
08/22/2020
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