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General NPI Number Information
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NPI Number | 1487431995
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Entity Type | Organization
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Legal Business Name | GOOD LIFE VIRTUAL CARE
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 3400 PLANTATION DR STE 100
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City | LINCOLN
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State | NE
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Zip | 68516-5199
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Country | US
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Telephone | 402-942-1444
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Fax | 531-242-4424
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Provider Business Mailing Address
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Address Line | 7431 NINA ST
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City | OMAHA
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State | NE
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Zip | 68124-4058
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Country | US
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Telephone | 402-942-1444
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Fax | 531-242-4424
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Authorized Official
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Title or Position | CEO
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Name | MRS. KRISTAL ANN TURPEN
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Credential | NURSE PRACTITIONER
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Telephone | 402-942-1444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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