Provider Demographics
NPI:1497851232
Name:HEIMBRECHT, KURT J (MD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:J
Last Name:HEIMBRECHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 N 86TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-3713
Mailing Address - Country:US
Mailing Address - Phone:402-327-7500
Mailing Address - Fax:
Practice Address - Street 1:1601 N 86TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-3713
Practice Address - Country:US
Practice Address - Phone:402-327-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-102944207Q00000X
NE28215207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036102944Medicaid
NE098147173Medicare PIN
H17212Medicare UPIN
IL036102944Medicaid