MEDICARE: MEANINGFUL PSYCHIATRIC SERVICES LLC

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1396293502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEANINGFUL PSYCHIATRIC SERVICES LLC

Provider Business Mailing Address
First Line	:	9338 FOREST GLEN DR
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68526-9636
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9338 FOREST GLEN DR
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68526-9636
Country	:	US
Telephone Number	:	402-469-6340
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LORI J SMITH
Credential	:	APRN
Telephone Number	:	402-469-6340

Provider Enumeration Date	:	09/15/2016
Last Update Date	:	09/15/2016

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