Basic Information
Provider Information
NPI: 1942706353
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEVIC
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MUSIL
OtherFirstName: SARAH
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 2900 S 70TH ST STE 450
Address2:  
City: LINCOLN
State: NE
PostalCode: 685066825
CountryCode: US
TelephoneNumber: 4024894186
FaxNumber: 4024895279
Practice Location
Address1: 2900 S 70TH ST STE 450
Address2:  
City: LINCOLN
State: NE
PostalCode: 68506
CountryCode: US
TelephoneNumber: 4024894186
FaxNumber: 4024895279
Other Information
ProviderEnumerationDate: 04/04/2018
LastUpdateDate: 06/27/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X70026NEN Nursing Service ProvidersRegistered Nurse 
367500000X101499NEY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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