Basic Information
| Provider Information | |||||||||
| NPI: | 1336489178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOONE | ||||||||
| FirstName: | GERMAINE | ||||||||
| MiddleName: | LOU | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RN, BSN, IBCLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8401 W DODGE RD STE 280 | ||||||||
| Address2: | CHILDREN'S PHYSICIANS | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681143493 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4029556877 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9202 W DODGE RD STE 101 | ||||||||
| Address2: | CHILDREN'S PHYSICIANS - EMBASSY PARK | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681143318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4029557500 | ||||||||
| FaxNumber: | 4029557524 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2013 | ||||||||
| LastUpdateDate: | 02/14/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WL0100X | 37625 | NE | Y | Nursing Service Providers | Registered Nurse | Lactation Consultant |
No ID Information.