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NPI Code Detail

MEDICARE: LENYDUER BOL

MEDICARE: LENYDUER BOL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1372600000XAdult Companion1710500525NE

General Provider Information

NPI Number : 1033066105
Entity Type Code : Individual
Provider Name (Legal Business Name) : LENYDUER BOL
Provider Business Mailing Address
First Line : 1400 DAHLBERG DR STE E
Second Line :
City : LINCOLN
State : NE
Zip : 68512-9217
Country : US
Telephone Number : 402-423-8119
Fax Number :
Provider Business Practice Location Address
First Line : 1400 DAHLBERG DR STE E
Second Line :
City : LINCOLN
State : NE
Zip : 68512-9217
Country : US
Telephone Number : 402-423-8119
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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Directions to “ LENYDUER BOL ” Practice Location

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