Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 1038 | NE |
N | 207NP0225X | Pediatric Dermatologist | 1038 | NE |
N | 207NS0135X | Procedural Dermatology | 1038 | NE |
NPI | 1295785525 |
---|---|
Provider Name | Mr. Brian Jean Herbin |
First Address | Lincoln, NE 68512-3665 |
Second Address | Lincoln, NE 68512-9371 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 16/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P61993 | (02) | NE |