Basic Information
Provider Information
NPI: 1316275233
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EKBERG-WOOD
FirstName: LANA
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: NP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 67250
Address2:  
City: LINCOLN
State: NE
PostalCode: 685067250
CountryCode: US
TelephoneNumber: 4023288833
FaxNumber: 8889650959
Practice Location
Address1: 4210 PIONEER WOODS DR A
Address2:  
City: LINCOLN
State: NE
PostalCode: 685067561
CountryCode: US
TelephoneNumber: 4024884321
FaxNumber: 4024884355
Other Information
ProviderEnumerationDate: 12/04/2009
LastUpdateDate: 07/30/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X111090NEY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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