Provider Demographics
NPI:1063301919
Name:KUKER, LORRAINE AGNES
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:AGNES
Last Name:KUKER
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 1:16317 ARBOR ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-1745
Mailing Address - Country:US
Mailing Address - Phone:402-697-8257
Mailing Address - Fax:
Practice Address - Street 1:7810 S 166TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136-3106
Practice Address - Country:US
Practice Address - Phone:402-697-8257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant