Provider Demographics
NPI:1326850363
Name:LUBBERS, BRADLEY JAY
Entity type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:JAY
Last Name:LUBBERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 S 170TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-3209
Mailing Address - Country:US
Mailing Address - Phone:402-706-3073
Mailing Address - Fax:
Practice Address - Street 1:6410 S 170TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-3209
Practice Address - Country:US
Practice Address - Phone:402-706-3073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care