Healthcare Provider Details

I. General information

NPI: 1518995455
Provider Name (Legal Business Name): WOMEN'S CLINIC OF LINCOLN, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 12/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 LYNCREST DRIVE
LINCOLN NE
68510
US

IV. Provider business mailing address

2900 S 70TH SUITE 310
LINCOLN NE
68506
US

V. Phone/Fax

Practice location:
  • Phone: 402-434-3370
  • Fax: 402-489-0731
Mailing address:
  • Phone: 402-434-5235
  • Fax: 402-484-8891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TRACY SCOW
Title or Position: OFFICE MANAGER
Credential:
Phone: 402-434-3370