Individual
GREGSTON R NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12728 AUGUSTA AVENUE, OMAHA, NE 68144-3754
(402) 330-1410
Mailing address
12728 AUGUSTA AVENUE, OMAHA, NE 68144-3754
(402) 330-1410
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20960
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00149
BLUE CROSS & BLUE SHIELD
NE
01
—
101523
UNITED HEALTHCARE
—
05
—
75304640000
—
NE
05
—
7560003
—
IA
01
—
91530
WELLMARK BCBS IA
IA
Enumeration date
10/04/2006
Last updated
07/08/2007
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