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 |