Provider Demographics
NPI:1043980022
Name:EFFENBECK, BRIGETT (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIGETT
Middle Name:
Last Name:EFFENBECK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 ROAD X
Mailing Address - Street 2:
Mailing Address - City:BRUNING
Mailing Address - State:NE
Mailing Address - Zip Code:68322-3005
Mailing Address - Country:US
Mailing Address - Phone:402-300-0308
Mailing Address - Fax:
Practice Address - Street 1:1840 F ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NE
Practice Address - Zip Code:68361-2211
Practice Address - Country:US
Practice Address - Phone:402-759-4485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NE2664207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant