Provider Demographics
NPI:1477859668
Name:BERNT, GREGORY S (BA)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:S
Last Name:BERNT
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 NORMAL BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5261
Mailing Address - Country:US
Mailing Address - Phone:402-261-4017
Mailing Address - Fax:402-261-4137
Practice Address - Street 1:3901 NORMAL BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5261
Practice Address - Country:US
Practice Address - Phone:402-261-4017
Practice Address - Fax:402-261-4137
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-04
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator