Healthcare Provider Details

I. General information

NPI: 1225463789
Provider Name (Legal Business Name): LINDSEY R JOHNSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY R TOLLEFSON

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 N 51ST ST STE 200
OMAHA NE
68132-2867
US

IV. Provider business mailing address

18924 EVANS ST STE 105
ELKHORN NE
68022-7038
US

V. Phone/Fax

Practice location:
  • Phone: 402-932-8020
  • Fax: 402-905-3042
Mailing address:
  • Phone: 531-466-8611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number111594
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number111594
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberB135264
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number120054
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: