Provider Demographics
NPI:1366239097
Name:BUCHHOLZ, BRANDON MICHAEL JR
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:MICHAEL
Last Name:BUCHHOLZ
Suffix:JR
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 1:8984 N 81ST ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-4103
Mailing Address - Country:US
Mailing Address - Phone:402-686-1302
Mailing Address - Fax:
Practice Address - Street 1:8984 N 81ST ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-4103
Practice Address - Country:US
Practice Address - Phone:402-686-1302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider