Healthcare Provider Details

I. General information

NPI: 1326901281
Provider Name (Legal Business Name): LAUREL PREVETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 W 5TH ST
HASTINGS NE
68901-5197
US

IV. Provider business mailing address

616 W 5TH ST
HASTINGS NE
68901-5197
US

V. Phone/Fax

Practice location:
  • Phone: 402-463-5684
  • Fax:
Mailing address:
  • Phone: 402-463-5684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberCPSS-472
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: