Provider Demographics
NPI:1215743653
Name:NGUIDJOL, LAUREN NANCY (LPN HBCS PROVIDER)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:NANCY
Last Name:NGUIDJOL
Suffix:
Gender:F
Credentials:LPN HBCS PROVIDER
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:NANCY
Other - Last Name:GRIGSBY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN HBCS PROVIDER
Mailing Address - Street 1:3333 MEREDITH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-2337
Mailing Address - Country:US
Mailing Address - Phone:531-225-9252
Mailing Address - Fax:
Practice Address - Street 1:3333 MEREDITH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-2337
Practice Address - Country:US
Practice Address - Phone:531-218-4903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15597164W00000X
NE372500000X, 372600000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion