Provider Demographics
NPI:1003318098
Name:HOHENFELDT, LAVONNE JEAN
Entity Type:Individual
Prefix:
First Name:LAVONNE
Middle Name:JEAN
Last Name:HOHENFELDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5021 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-3264
Mailing Address - Country:US
Mailing Address - Phone:402-436-1164
Mailing Address - Fax:
Practice Address - Street 1:5021 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-3264
Practice Address - Country:US
Practice Address - Phone:402-436-1164
Practice Address - Fax:402-458-3264
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3329164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse