Provider Demographics
NPI:1750487369
Name:BISKUP, GARY (RN)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:BISKUP
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22749
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68542-2749
Mailing Address - Country:US
Mailing Address - Phone:402-730-2179
Mailing Address - Fax:
Practice Address - Street 1:2811 TIERRA DR
Practice Address - Street 2:# 111
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5013
Practice Address - Country:US
Practice Address - Phone:402-730-2179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE52221163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health