Provider Demographics
NPI:1447335500
Name:BRONSON, JOANNE E (CNM)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:E
Last Name:BRONSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S 70TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2452
Mailing Address - Country:US
Mailing Address - Phone:402-483-7641
Mailing Address - Fax:402-483-0527
Practice Address - Street 1:301 S 70TH ST STE 200
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2452
Practice Address - Country:US
Practice Address - Phone:402-483-7641
Practice Address - Fax:402-483-0527
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE120002207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47-0546525-12Medicaid
279625Medicare ID - Type Unspecified
NE47-0546525-12Medicaid