Organization
KATHERINEZUPANCICMACPCLPCPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARMEN JOYCE SANDELL RETIRED R.N. (ASSISTANT OFFICE MANAGER)
(402) 476-3002
Entity
Organization
Contact information
Practice address
301 S 13TH ST, SUITE 200, LINCOLN, NE 68508-2537
(402) 476-3002
(402) 476-3002
Mailing address
301 S 13TH ST, SUITE 200, LINCOLN, NE 68508-2537
(402) 476-3002
(402) 476-3002
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
301 & 397
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84413
BCBS
NE
01
—
MHS093572
VALUE OPTIONS
NE
Enumeration date
12/29/2006
Last updated
06/26/2008
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