Healthcare Provider Details

I. General information

NPI: 1053939710
Provider Name (Legal Business Name): NEW LIFE OBSTETRICS AND GYNECOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S 70TH ST STE 220
LINCOLN NE
68510-7901
US

IV. Provider business mailing address

1001 S 70TH ST STE 220
LINCOLN NE
68510-7901
US

V. Phone/Fax

Practice location:
  • Phone: 402-486-4800
  • Fax: 402-486-1459
Mailing address:
  • Phone: 402-486-4800
  • Fax: 402-486-1459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALECIA SUSAN LOVEGROVE
Title or Position: MBR
Credential: MD
Phone: 402-486-4800