Healthcare Provider Details

I. General information

NPI: 1134059355
Provider Name (Legal Business Name): LANITA KNOKE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17010 WRIGHT PLZ STE 145
OMAHA NE
68130-4659
US

IV. Provider business mailing address

208 AUGUSTA DR
TREYNOR IA
51575-7366
US

V. Phone/Fax

Practice location:
  • Phone: 402-670-9097
  • Fax:
Mailing address:
  • Phone: 402-670-9097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License Number075872
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: