Healthcare Provider Details

I. General information

NPI: 1518685254
Provider Name (Legal Business Name): LAURIE CHRISTINE SEWELL-MULLER DNP, ARNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. LAURIE SEWELL

II. Dates (important events)

Enumeration Date: 08/18/2022
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6910 PACIFIC ST STE 100
OMAHA NE
68106-1044
US

IV. Provider business mailing address

6910 PACIFIC ST STE 100
OMAHA NE
68106-1044
US

V. Phone/Fax

Practice location:
  • Phone: 402-504-3707
  • Fax: 402-504-3714
Mailing address:
  • Phone: 402-504-3707
  • Fax: 402-504-3714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG170435
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: