Healthcare Provider Details

I. General information

NPI: 1063742948
Provider Name (Legal Business Name): SUZY MEYERS IBCLC, RLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2009
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5930 S 58TH ST SUITE W
LINCOLN NE
68516-6402
US

IV. Provider business mailing address

5930 S 58TH ST SUITE W
LINCOLN NE
68516-6402
US

V. Phone/Fax

Practice location:
  • Phone: 402-423-6402
  • Fax: 402-423-6422
Mailing address:
  • Phone: 402-423-6402
  • Fax: 402-423-6422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: