Healthcare Provider Details

I. General information

NPI: 1952585440
Provider Name (Legal Business Name): LORI K.S. HURT MA, PLMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2007
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N COTNER STE 302
LINCOLN NE
68505
US

IV. Provider business mailing address

7901 W WALIN LANE
LINCOLN NE
68532
US

V. Phone/Fax

Practice location:
  • Phone: 402-217-3198
  • Fax:
Mailing address:
  • Phone: 402-217-3198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number8502
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: