Individual
NYADENG N/A RUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7200 S 84TH ST, LA VISTA, NE 68128-2115
(531) 999-2503
Mailing address
7200 S 84TH ST, LA VISTA, NE 68128-2115
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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