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General NPI Number Information
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NPI Number | 1013292176
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Entity Type | Individual
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Provider Name | DR. AMANDA MARIE LAUSEN
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Gender | Female
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Dates
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Enumeration Date | 10/19/2011
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 2502 N 48TH ST
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City | LINCOLN
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State | NE
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Zip | 68504-3629
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Country | US
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Telephone | 402-466-1424
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Fax |
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Provider Business Mailing Address
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Address Line | 2924 CHANNEL DR
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City | LINCOLN
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State | NE
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Zip | 68516-4985
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Country | US
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Telephone | 402-630-2769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12886
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 20742
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License Number State | IA
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