Individual
LACEY GOTTULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8445 ANDERMATT DR, LINCOLN, NE 68526-9746
(402) 328-4700
Mailing address
8445 ANDERMATT DR, LINCOLN, NE 68526-9746
(402) 328-4700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
74152
NE
363LF0000X
Family Nurse Practitioner
Primary
112176
NE
Other
Enumeration date
01/30/2017
Last updated
02/06/2017
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