Provider Demographics
NPI:1316235989
Name:LIFEARTS MEDICAL LLC
Entity type:Organization
Organization Name:LIFEARTS MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-296-2196
Mailing Address - Street 1:546 AVENUE A
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PLATTSMOUTH
Mailing Address - State:NE
Mailing Address - Zip Code:68048-1993
Mailing Address - Country:US
Mailing Address - Phone:402-296-2196
Mailing Address - Fax:402-296-2197
Practice Address - Street 1:546 AVENUE A
Practice Address - Street 2:SUITE 2
Practice Address - City:PLATTSMOUTH
Practice Address - State:NE
Practice Address - Zip Code:68048-1993
Practice Address - Country:US
Practice Address - Phone:402-296-2196
Practice Address - Fax:402-296-2197
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFEARTS INTEGRATED HEALTH CENTER PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-18
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty