| Organization Name: | ALEGENT CREIGHTON CLINIC |
| NPI Number: | 1285082917 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEITH JANKUSKI (COO) |
| Mailing Address: | 1413 S Washington St Ste 200 Papillion |
| State: | NE US |
| Postal Code: | 680464165 |
| Phone Number: | 4027170820 |
| Fax Number: | 4027170830 |
| NPI Enumeration Date: | 06/03/2016 |
| NPI Last Update Date: | 06/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NE |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |