Individual
DR. JOHN C. ANDRESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18018 BURKE STREET, ELKHORN, NE 68022-4417
(402) 573-7337
(402) 614-2314
Mailing address
PO BOX 31582, OMAHA, NE 68131-0582
(402) 573-7337
(402) 614-2314
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22078
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025373200
—
NE
01
—
239187
MIDLANDS CHOICE
NE
01
—
994
BCBS
NE
Enumeration date
09/29/2006
Last updated
06/02/2016
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