Individual
JILL LAVENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5905 O ST, LINCOLN, NE 68510-2235
(402) 436-1905
Mailing address
2945 OMALLEY CIR, LINCOLN, NE 68516-5808
(402) 261-8968
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
839
NE
Other
Enumeration date
08/21/2015
Last updated
08/21/2015
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