Provider Demographics
NPI:1053811091
Name:FRANCENE D. BUDA DARDON, MS, PC
Entity type:Organization
Organization Name:FRANCENE D. BUDA DARDON, MS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCENE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUDA-DARDON
Authorized Official - Suffix:
Authorized Official - Credentials:CSW
Authorized Official - Phone:402-320-8220
Mailing Address - Street 1:701 OLSON DR STE 109
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4797
Mailing Address - Country:US
Mailing Address - Phone:402-320-8220
Mailing Address - Fax:402-330-9587
Practice Address - Street 1:701 OLSON DR STE 109
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4797
Practice Address - Country:US
Practice Address - Phone:402-320-8220
Practice Address - Fax:402-330-9587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE573261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE739037000Medicaid