Connie Lake
Technician, Personal Care Attendant in Lincoln, NE. Individual provider (NPI-1).
NPI number1710627872
StatusActive
Last updated in NPPESMar 29, 2022
Details
- NPI
- 1710627872
- Entity type
- Individual (NPI-1)
- Name
- Connie Lake
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 29, 2022
- Certification date
- Mar 29, 2022
- Last updated
- Mar 29, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
Practice location
5905 O StLincoln, NE 68510-2235
Phone 402-436-1905
Mailing address
5905 O StLincoln, NE 68510-2235
Phone 402-436-1905
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