| Proactive Wound Care Ne Inc | |
|
650 J St Ste 405, Lincoln, NE 68508-2924 | |
| (801) 815-6500 | |
| Not Available |
| Full Name | Proactive Wound Care Ne Inc |
|---|---|
| Type | Facility |
| Speciality | Nurse Practitioner |
| Location | 650 J St Ste 405, Lincoln, Nebraska |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134943780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | Krista Ann Leasure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841841491 PECOS PAC ID: 5496183618 Enrollment ID: I20200320001916 |
| Provider Name | Kenneth Sherman Blocher |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1992745327 PECOS PAC ID: 6608813423 Enrollment ID: I20240814003841 |
| Provider Name | Nathan Brian Payne |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1760845473 PECOS PAC ID: 5193018976 Enrollment ID: I20250430003291 |
| Provider Name | Bryan Joseph Williams |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1508215179 PECOS PAC ID: 1456688936 Enrollment ID: I20250430003437 |
| Provider Name | Jaime Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124979307 PECOS PAC ID: 6406322577 Enrollment ID: I20260416000496 |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Wound Care Ne Inc Po Box 607, Centerville, UT 84014-0607 Ph: (801) 815-6500 | Proactive Wound Care Ne Inc 650 J St Ste 405, Lincoln, NE 68508-2924 Ph: (801) 815-6500 |