Healthcare Provider Details

I. General information

NPI: 1376963223
Provider Name (Legal Business Name): MAGGIE GLAWATZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2014
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 PIONEER WOODS DR
LINCOLN NE
68506-7548
US

IV. Provider business mailing address

820 S 38TH STREET CT STE 2
LINCOLN NE
68510-3566
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-4900
  • Fax: 402-484-6456
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61499317
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number111629
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: