Healthcare Provider Details

I. General information

NPI: 1215693890
Provider Name (Legal Business Name): VYANNE LEE ZINK LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4780 LINDEN ST STE 1
LINCOLN NE
68516-1180
US

IV. Provider business mailing address

4780 LINDEN ST STE 1
LINCOLN NE
68516-1180
US

V. Phone/Fax

Practice location:
  • Phone: 402-416-9324
  • Fax:
Mailing address:
  • Phone: 402-416-9324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number3035
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: