Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 110880 | NE |
NPI | 1013108505 |
---|---|
Provider Name | Dana A Lynch |
First Address | Omaha, NE 68114-4057 |
Second Address | Omaha, NE 68114-4057 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2007 |
Last Update Date | 08/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10025290600 | (05) | NE |
47077295213 | (05) | NE |