Healthcare Provider Details

I. General information

NPI: 1477270122
Provider Name (Legal Business Name): LNK WELLNESS CARE AND AESTHETICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S 70TH ST STE 105
LINCOLN NE
68510-7901
US

IV. Provider business mailing address

1001 S 70TH ST STE 105
LINCOLN NE
68510-7901
US

V. Phone/Fax

Practice location:
  • Phone: 531-530-0328
  • Fax:
Mailing address:
  • Phone: 531-530-0328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CARRIE WALES
Title or Position: APRN-NP
Credential: NP
Phone: 531-530-0328