| NPI | 1740679463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LEMON Owner 402-540-6365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 110205) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 965) |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2015-02-19 |