Organization

Ponca Tribe Of Nebraska

Health Service Clinic/Center in Omaha, NE(View on Map)

Legal Business Name

Ponca Tribe Of Nebraska

NPI Number

1740681832

NPI Type

Organization

Enumeration Date

09/09/2014

Specialties

(Taxonomies)

Code

261QH0100X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

2602 J ST
2602 J ST

City

Omaha
Omaha

State

NE
NE

Postal Code

68107-1643
68107-1643

Country

US
US

Telephone Number

(402) 734-5275
(402) 734-5275

Authorized Official

Name

Ms. Kathy Rieb

Title or Position

CONTRACT SERVICE ADMINISTRATOR

Telephone Number

(402) 738-3175

Identifiers

Identifier

1155
86004356

Identifier State

NE
NE

Identifier Issuer

LICENSED MEDICAL NUTRITION THERAPIST
COMMISSION ON DIETETIC REGISTRATION

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/09/2014

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