Provider Demographics
NPI:1053106906
Name:FOOT AND ANKLE CENTER OF NEBRASKA, P.C.
Entity type:Organization
Organization Name:FOOT AND ANKLE CENTER OF NEBRASKA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ROSALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KREIGHBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-909-1920
Mailing Address - Street 1:PO BOX 825159
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-5159
Mailing Address - Country:US
Mailing Address - Phone:866-626-1540
Mailing Address - Fax:
Practice Address - Street 1:1226 N WASHINGTON ST STE 103
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-3107
Practice Address - Country:US
Practice Address - Phone:402-391-7575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site