Individual
MRS. MOLLY LAUREN HANNASCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.- C
Contact information
Practice address
1550 S 70TH ST, SUITE 202, LINCOLN, NE 68506-1576
(402) 328-8833
(402) 328-2921
Mailing address
PO BOX 6971, LINCOLN, NE 68506-0971
(402) 486-7083
(402) 434-6047
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1457
NE
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24384
BCBS
NE
01
—
N/A
MIDLANDS CHOICE
NE
Enumeration date
07/27/2009
Last updated
12/04/2015
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