Individual
MISS MARTINA EVONNE BASCOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 PENROSE DRIVE, LINCOLN, NE 68521
(402) 436-1222
(402) 458-3222
Mailing address
5905 O ST, LINCOLN, NE 68510-2235
(402) 436-1657
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
NE
Other
Enumeration date
01/03/2023
Last updated
01/03/2023
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