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Individual

SARA THERESA DOLEZAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN BSN IBCLC

Contact information

Practice address
18018 BURKE ST, ELKHORN, NE 68022-4417
(402) 573-7337
Mailing address
18018 BURKE ST, ELKHORN, NE 68022-4417
(402) 573-7337

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
87901
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
57901
PRIVATE
NE
05
57901
NE
Enumeration date
08/07/2019
Last updated
08/07/2019
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