Healthcare Provider Details

I. General information

NPI: 1710785316
Provider Name (Legal Business Name): LAUREEN MARIE ACKERMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 S 42ND ST STE 122
OMAHA NE
68105-2942
US

IV. Provider business mailing address

1941 S 42ND ST STE 122
OMAHA NE
68105-2942
US

V. Phone/Fax

Practice location:
  • Phone: 402-346-5220
  • Fax: 402-342-4857
Mailing address:
  • Phone: 402-346-5220
  • Fax: 402-342-4857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: