NPI Profile for PEMBERLY PLACE MEDICAL CLINIC LLC in LINCOLN, NE.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner | |
Gerontology |
363LG0600X | 50 | Nurse Practitioner |
| NPI Number | 1396231692 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 07/10/2018 | |
| Last updated | 07/10/2018 - About 8 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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PEMBERLY PLACE MEDICAL CLINIC LLC
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