Individual
LORRAINE MYERS PROVENCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4909 S 118TH ST, OMAHA, NE 68137-2213
(402) 506-9970
(605) 371-7199
Mailing address
4909 S 118TH ST, OMAHA, NE 68137-2213
(402) 506-9970
(605) 371-7199
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35854
NE
Other
Enumeration date
05/28/2014
Last updated
05/21/2024
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