Individual
TANYA LLANQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6901 S 84TH ST, LA VISTA, NE 68128-2127
(866) 389-2727
Mailing address
6901 S 84TH ST, LA VISTA, NE 68128-2127
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
111778
NE
Other
Enumeration date
04/15/2015
Last updated
08/01/2023
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