Healthcare Provider Details

I. General information

NPI: 1336154780
Provider Name (Legal Business Name): REBECCA S. ROSS RD, LMNT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS REBECCA S. LENHOFF

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 S 42ND ST SUITE 225
OMAHA NE
68105-2939
US

IV. Provider business mailing address

1941 S 42ND ST SUITE 225
OMAHA NE
68105-2939
US

V. Phone/Fax

Practice location:
  • Phone: 402-342-5566
  • Fax: 402-342-0034
Mailing address:
  • Phone: 402-342-5566
  • Fax: 402-342-0034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number702
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: