Healthcare Provider Details

I. General information

NPI: 1699434928
Provider Name (Legal Business Name): LORNA PAGE MONAGHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2021
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8303 DODGE ST STE 300
OMAHA NE
68114-4108
US

IV. Provider business mailing address

8303 DODGE ST STE 300
OMAHA NE
68114-4108
US

V. Phone/Fax

Practice location:
  • Phone: 402-354-5250
  • Fax: 402-354-3437
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: