Provider Demographics
NPI:1366849333
Name:KEARNEY PHYSICIAN NETWORK LLC
Entity Type:Organization
Organization Name:KEARNEY PHYSICIAN NETWORK LLC
Other - Org Name:DBA LINCOLN ANESTHESIOLOGY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REX
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:RECKEWEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-421-0896
Mailing Address - Street 1:575 S 70TH ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2471
Mailing Address - Country:US
Mailing Address - Phone:402-434-5600
Mailing Address - Fax:402-434-5601
Practice Address - Street 1:575 S 70TH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2471
Practice Address - Country:US
Practice Address - Phone:402-434-5600
Practice Address - Fax:402-434-5601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE PHYSICIAN NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE207L00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty