Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 112071 | NE |
NPI | 1336692714 |
---|---|
Provider Name | Carly Leann Maack-Chee |
First Address | Lincoln, NE 68510-3702 |
Second Address | Lincoln, NE 68510-3702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2016 |
Last Update Date | 02/08/2016 |