Individual
MR. DANIEL LYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPT, LFC
Contact information
Practice address
2660 N 72ND ST, OMAHA, NE 68134-7028
(402) 618-2579
Mailing address
2660 N 72ND ST, OMAHA, NE 68134-7028
(402) 618-2579
Taxonomy
Speciality
Code
Description
License number
State
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
833993092
BLUE CROSS BLUE SHIELD
NE
05
—
833993092
—
NE
Enumeration date
12/30/2019
Last updated
12/30/2019
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