Individual
CARLA SUE CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4501 S 70TH ST, SUITE 140, LINCOLN, NE 68516-4201
(402) 484-5100
(402) 484-5151
Mailing address
4501 S 70TH ST, SUITE 140, LINCOLN, NE 68516-4201
(402) 484-5100
(402) 484-5151
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
844
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2010
Last updated
06/13/2014
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