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NPI Code Detail

MEDICARE: MRS. MACY ANN LAUX APRN, FNP-C

MEDICARE: MRS. MACY ANN LAUX APRN, FNP-C
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
1363LF0000XFamily Nurse Practitioner114012NE

General Provider Information

NPI Number : 1225780281
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MACY ANN LAUX APRN, FNP-C
Provider Business Mailing Address
First Line : 7812 S 70TH ST
Second Line :
City : LA VISTA
State : NE
Zip : 68128-3000
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 312 OLSON DR STE 101
Second Line :
City : PAPILLION
State : NE
Zip : 68046-2981
Country : US
Telephone Number : 402-382-9117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2022
Last Update Date : 01/21/2022

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