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Individual

DARIN J MONGEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
575 S 70TH ST, SUITE 200, LINCOLN, NE 68510-2471
(402) 488-3322
(402) 488-1172
Mailing address
575 S 70TH ST, SUITE 200, LINCOLN, NE 68510-2471
(402) 488-3322
(402) 488-1172

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
859
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47061995513
NE
05
47070309913
NE
Enumeration date
12/06/2005
Last updated
03/09/2015
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