Healthcare Provider Details

I. General information

NPI: 1689253379
Provider Name (Legal Business Name): LAUREN EMILY COSTELLO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN EMILY GREUFE MD

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

S 42ND & EMILE ST
OMAHA NE
68198-3438
US

IV. Provider business mailing address

21426 PARKVIEW DR
GRETNA NE
68028-3993
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number37433
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: