Individual
LIZANDRA BOULLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
817 E 14 TH ST, CRETE, NE 68333
(402) 821-8459
Mailing address
2245 HEATHER DR APT 5, CRETE, NE 68333-9421
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
06/27/2025
Last updated
06/27/2025
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