Provider Demographics
NPI:1982604237
Name:ESSINK, BRANDON JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:JAMES
Last Name:ESSINK
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:PO BOX 255
Mailing Address - Street 2:
Mailing Address - City:CREIGHTON
Mailing Address - State:NE
Mailing Address - Zip Code:68729-0255
Mailing Address - Country:US
Mailing Address - Phone:402-358-5763
Mailing Address - Fax:402-358-5797
Practice Address - Street 1:1503 MAIN ST
Practice Address - Street 2:
Practice Address - City:CREIGHTON
Practice Address - State:NE
Practice Address - Zip Code:68729-3007
Practice Address - Country:US
Practice Address - Phone:402-358-5763
Practice Address - Fax:402-358-5797
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22302207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7715180Medicaid
IA1982604237Medicaid
NE47062784612Medicaid
NE244393OtherMIDLANDS CHOICE
NE04412OtherBCBS OF NE
IA1982604237Medicaid
NE04412OtherBCBS OF NE
NE244393OtherMIDLANDS CHOICE