Healthcare Provider Details

I. General information

NPI: 1487431995
Provider Name (Legal Business Name): GOOD LIFE VIRTUAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 09/11/2023
Certification Date: 09/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 PLANTATION DR STE 100
LINCOLN NE
68516-5199
US

IV. Provider business mailing address

7431 NINA ST
OMAHA NE
68124-4058
US

V. Phone/Fax

Practice location:
  • Phone: 402-942-1444
  • Fax: 531-242-4424
Mailing address:
  • Phone: 402-942-1444
  • Fax: 531-242-4424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRISTAL ANN TURPEN
Title or Position: CEO
Credential: NURSE PRACTITIONER
Phone: 402-942-1444