Healthcare Provider Details

I. General information

NPI: 1053124149
Provider Name (Legal Business Name): BONNIE LUBEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 WESTLAWN AVE
HASTINGS NE
68901-4727
US

IV. Provider business mailing address

502 MAPLE ST
OAK NE
68964-8200
US

V. Phone/Fax

Practice location:
  • Phone: 402-705-6346
  • Fax:
Mailing address:
  • Phone: 402-705-6346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: