Individual
TIMOTHY J YRASTORZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4740 A ST, SUITE 100, LINCOLN, NE 68510-4824
(402) 483-7825
(402) 483-7839
Mailing address
4740 A ST, SUITE 100, LINCOLN, NE 68510-4824
(402) 483-7825
(402) 483-7839
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
1213
NE
363AS0400X
Surgical Physician Assistant
Primary
966
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47059807113
—
NE
Enumeration date
12/08/2005
Last updated
02/14/2012
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