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Individual

MARK FUNK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
52550 848TH RD, NELIGH, NE 68756-2026
(402) 649-1629
Mailing address
320 3RD ST, COLUMBUS, NE 68601-7808
(402) 649-1629

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
80622
NE
367500000X
Certified Registered Nurse Anesthetist
Primary
101708
NE

Other

Enumeration date
06/23/2021
Last updated
06/01/2022
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