Healthcare Provider Details

I. General information

NPI: 1316235989
Provider Name (Legal Business Name): LIFEARTS MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 08/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

546 AVENUE A SUITE 2
PLATTSMOUTH NE
68048-1993
US

IV. Provider business mailing address

546 AVENUE A SUITE 2
PLATTSMOUTH NE
68048-1993
US

V. Phone/Fax

Practice location:
  • Phone: 402-296-2196
  • Fax: 402-296-2197
Mailing address:
  • Phone: 402-296-2196
  • Fax: 402-296-2197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number111219
License Number StateNE

VIII. Authorized Official

Name: JULIE M HOWARD
Title or Position: OWNER
Credential:
Phone: 402-296-2196