Individual
JONATHAN BLAKE ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACNPC-AG
Contact information
Practice address
4508 38TH ST STE 157, COLUMBUS, NE 68601-1668
(402) 564-7756
Mailing address
7440 S 91ST ST, LINCOLN, NE 68526-9797
(402) 564-7756
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
116265
NE
Other
Enumeration date
08/30/2025
Last updated
08/30/2025
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