Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 27243 | NE |
NPI | 1013066315 |
---|---|
Provider Name | Malinda J Bender |
First Address | Bellevue, NE 68133-4711 |
Second Address | Bellevue, NE 68133-4711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 19/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10026303200 | (05) | NE |