Provider Demographics
NPI:1336489178
Name:BOONE, GERMAINE LOU (RN, BSN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:GERMAINE
Middle Name:LOU
Last Name:BOONE
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 W DODGE RD STE 280
Mailing Address - Street 2:CHILDREN'S PHYSICIANS
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3493
Mailing Address - Country:US
Mailing Address - Phone:402-955-6877
Mailing Address - Fax:
Practice Address - Street 1:9202 W DODGE RD STE 101
Practice Address - Street 2:CHILDREN'S PHYSICIANS - EMBASSY PARK
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3318
Practice Address - Country:US
Practice Address - Phone:402-955-7500
Practice Address - Fax:402-955-7524
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE37625163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant