Provider Demographics
NPI:1376178970
Name:EDWARDS, SEBASTIAN EUGENE (CRNA)
Entity Type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:EUGENE
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 S 70TH STREET
Mailing Address - Street 2:SUITE # 450
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-3796
Mailing Address - Country:US
Mailing Address - Phone:402-489-4186
Mailing Address - Fax:402-489-5279
Practice Address - Street 1:2900 S 70TH STREET
Practice Address - Street 2:SUITE # 450
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-3796
Practice Address - Country:US
Practice Address - Phone:402-489-4186
Practice Address - Fax:402-489-5279
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE101577367500000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered