Provider Demographics
NPI:1104932656
Name:GUTHMANN, LANETTE M (MD)
Entity type:Individual
Prefix:DR
First Name:LANETTE
Middle Name:M
Last Name:GUTHMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3755
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-0755
Mailing Address - Country:US
Mailing Address - Phone:402-354-2100
Mailing Address - Fax:402-354-2155
Practice Address - Street 1:8901 W DODGE RD
Practice Address - Street 2:STE # 200B
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3321
Practice Address - Country:US
Practice Address - Phone:402-354-1700
Practice Address - Fax:402-354-1747
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17247207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026301600Medicaid
NE47068731799Medicaid
IA1104932656Medicaid
IA1104932656Medicaid
D05159Medicare UPIN
NE279743Medicare PIN