Provider Demographics
NPI:1316221385
Name:BRYANLGH WEST MEDICAL CENTER
Entity Type:Organization
Organization Name:BRYANLGH WEST MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:OVERHALSER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:402-481-4167
Mailing Address - Street 1:2046 HEREL ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-3682
Mailing Address - Country:US
Mailing Address - Phone:402-481-4167
Mailing Address - Fax:402-481-5100
Practice Address - Street 1:2046 HEREL ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-3682
Practice Address - Country:US
Practice Address - Phone:402-481-4167
Practice Address - Fax:402-481-5100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111296282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital