Lynde Roach
Licensed Practical Nurse in Omaha, NE. Individual provider (NPI-1).
NPI number1104776772
StatusActive
Last updated in NPPESFeb 2, 2026
Details
- NPI
- 1104776772
- Entity type
- Individual (NPI-1)
- Name
- Lynde Roach
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 2, 2026
- Certification date
- Feb 2, 2026
- Last updated
- Feb 2, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 28415 | NE | Yes |
Practice location
220 N 89th St Ste 202Ste 202
Omaha, NE 68114-4072
Phone 402-502-5750
Mailing address
220 N 89th St Ste 202Omaha, NE 68114-4072
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 203 Licensed Practical Nurse providers in Omaha · All 40,392 providers in Omaha
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