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General NPI Number Information
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NPI Number | 1649169160
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Entity Type | Individual
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Provider Name | MARIAH KATE LANUM
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 5801 HIDCOTE DR
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City | LINCOLN
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State | NE
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Zip | 68516-5568
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Country | US
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Telephone | 402-665-4687
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Fax |
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Provider Business Mailing Address
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Address Line | 11952 N 143RD ST
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City | WAVERLY
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State | NE
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Zip | 68462-1165
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Country | US
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Telephone | 531-739-7107
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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 | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number | 161696
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License Number State | NE
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