Provider Demographics
NPI:1598578999
Name:BITTNER, RYAN C
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:C
Last Name:BITTNER
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 1:2753 N HWS CLEVELAND BLVD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-2686
Mailing Address - Country:US
Mailing Address - Phone:402-960-7288
Mailing Address - Fax:
Practice Address - Street 1:2753 N HWS CLEVELAND BLVD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-2686
Practice Address - Country:US
Practice Address - Phone:402-960-7288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator