Healthcare Provider Details

I. General information

NPI: 1316275233
Provider Name (Legal Business Name): LANA MARIE EKBERG-WOOD NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2009
Last Update Date: 07/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4210 PIONEER WOODS DR A
LINCOLN NE
68506-7561
US

IV. Provider business mailing address

PO BOX 67250
LINCOLN NE
68506-7250
US

V. Phone/Fax

Practice location:
  • Phone: 402-488-4321
  • Fax: 402-488-4355
Mailing address:
  • Phone: 402-328-8833
  • Fax: 888-965-0959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number111090
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: