Provider Demographics
NPI:1982402749
Name:WERMERS, GREGORY LEE
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:LEE
Last Name:WERMERS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 N GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-3608
Mailing Address - Country:US
Mailing Address - Phone:402-720-1424
Mailing Address - Fax:
Practice Address - Street 1:1440 N GARFIELD ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-3608
Practice Address - Country:US
Practice Address - Phone:402-720-1424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE3747P1801XMedicaid