Provider Demographics
NPI:1821109257
Name:HORACEK, ANKE (MD)
Entity Type:Individual
Prefix:
First Name:ANKE
Middle Name:
Last Name:HORACEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANKE
Other - Middle Name:
Other - Last Name:GILLESPIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2797
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-2797
Mailing Address - Country:US
Mailing Address - Phone:402-354-4230
Mailing Address - Fax:402-354-6171
Practice Address - Street 1:8303 DODGE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4108
Practice Address - Country:US
Practice Address - Phone:402-354-4424
Practice Address - Fax:402-354-4435
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22897207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1821109257Medicaid
NE47037660412Medicaid
NE04288OtherBCBS
IA0589952Medicaid
KS200311510AMedicaid
MO207224601Medicaid
MS207224601Medicaid
244056OtherMIDLAND'S CHOICE
SD7716410Medicaid
KS200311510AMedicaid
278693Medicare PIN
G69095Medicare UPIN
SD7716410Medicaid