Healthcare Provider Details

I. General information

NPI: 1780518670
Provider Name (Legal Business Name): LAUREN KIRK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 DEWEY AVE
OMAHA NE
68105-1017
US

IV. Provider business mailing address

3618 FARNAM ST 106
OMAHA NE
68131-3235
US

V. Phone/Fax

Practice location:
  • Phone: 402-552-2000
  • Fax:
Mailing address:
  • Phone: 402-215-1044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: