Healthcare Provider Details

I. General information

NPI: 1033047550
Provider Name (Legal Business Name): LYNN'S WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4640 N 83RD AVENUE CIR
OMAHA NE
68134-3212
US

IV. Provider business mailing address

4640 N 83RD AVENUE CIR
OMAHA NE
68134-3212
US

V. Phone/Fax

Practice location:
  • Phone: 402-990-8585
  • Fax:
Mailing address:
  • Phone: 402-990-8585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: WENDESONGDE NIKIEMA
Title or Position: OWNER
Credential:
Phone: 402-990-8585