| NPI | 1639568389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LUETHKE Billing Manager 402-646-5052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 111736) |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2015-05-04 |