Individual
CHERIE S LODL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2510 S 171ST CT, OMAHA, NE 68130-2394
(402) 330-3063
(402) 334-4418
Mailing address
2510 S 171ST CT, OMAHA, NE 68130-2394
(402) 330-3063
(402) 334-4418
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1042
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15477
SPECTERA
NE
01
—
2200244
UNITED HEALTHCARE
NE
01
—
36713
BLUE CROSS BLUE SHIELD
NE
01
—
470833584
TAX IDENTIFICATION NUMBER
NE
01
—
86956
COVENTRY
NE
01
—
NE1042
MUTUALLY PREFERRED
NE
01
—
O10900916
EXCLUSIVECARE
NE
Enumeration date
06/09/2005
Last updated
05/13/2008
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