Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 2663 | NE |
NPI | 1003265190 |
---|---|
Provider Name | Mrs. Rachel Jean Moormeier |
First Address | Lincoln, NE 68516-3246 |
Second Address | Lincoln, NE 68516-3246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2016 |
Last Update Date | 08/06/2016 |