Healthcare Provider Details

I. General information

NPI: 1669383048
Provider Name (Legal Business Name): MEADOWLARK PRIMARY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 FALLBROOK BLVD STE 112
LINCOLN NE
68521-9025
US

IV. Provider business mailing address

570 FALLBROOK BLVD STE 112
LINCOLN NE
68521-9025
US

V. Phone/Fax

Practice location:
  • Phone: 402-277-9537
  • Fax:
Mailing address:
  • Phone: 402-277-9537
  • Fax:

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: LORELII LEWIS
Title or Position: PHYSICIAN, FOUNDER
Credential: MD
Phone: 402-277-9537