Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Grandgen, LLC

Organization Specialist · NPI 1326351651

Grandgen, LLC is a Specialist in Omaha, Nebraska. Licensed in Iowa. Registered with an NPI since 2010.

Licensed in
IA
In the registry since
2010
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9802 Nicholas St Ste 305
Omaha, NE 68114-2167
Phone: (402) 397-2300
Fax: (402) 397-2303
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 23224 (IA)

Record details

NPI number1326351651
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jon Fulcher — President · (402) 445-6173
Other names Devenu Medical Rejuvenation Center
NPI enumeratedJuly 15, 2010
Last updated in NPPESJuly 15, 2010
Mailing address9802 Nicholas St, Suite 305, Omaha, NE 68114-2167

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