Provider Demographics
NPI:1033649884
Name:CEDAR PLAINS FAMILY MEDICINE
Entity Type:Organization
Organization Name:CEDAR PLAINS FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPOHN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN-NP, FNP-BC
Authorized Official - Phone:402-792-0095
Mailing Address - Street 1:1201 PARK DRIVE
Mailing Address - Street 2:CEDAR PLAINS FAMILY MEDICINE
Mailing Address - City:HICKMAN
Mailing Address - State:NE
Mailing Address - Zip Code:68372
Mailing Address - Country:US
Mailing Address - Phone:402-440-7923
Mailing Address - Fax:
Practice Address - Street 1:1201 PARK DR
Practice Address - Street 2:
Practice Address - City:HICKMAN
Practice Address - State:NE
Practice Address - Zip Code:68372-1448
Practice Address - Country:US
Practice Address - Phone:402-792-0095
Practice Address - Fax:402-792-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111178363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty