MEDICARE: LORNELL MCPHERSON

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	3747A0650X	Attendant Care Provider

General Provider Information

NPI Number	:	1912896564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORNELL MCPHERSON

Provider Business Mailing Address
First Line	:	1356 S 196TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68130-2954
Country	:	US
Telephone Number	:	402-968-4883
Fax Number	:

Provider Business Practice Location Address
First Line	:	1356 S 196TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68130-2954
Country	:	US
Telephone Number	:	402-968-4883
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2025
Last Update Date	:	06/30/2025

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Directions to “ LORNELL MCPHERSON ” Practice Location

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