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Individual

AUTUMN R LIGHTNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3340 N 56TH ST, OMAHA, NE 68104-3522
(402) 452-6447
Mailing address
3340 N 56TH ST, OMAHA, NE 68104-3522
(402) 452-6447

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
2404093654
NE

Other

Enumeration date
12/02/2024
Last updated
12/02/2024
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