Provider Demographics
NPI:1336692714
Name:MAACK-CHEE, CARLY LEANN (APRN)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:LEANN
Last Name:MAACK-CHEE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 S 45TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-3702
Mailing Address - Country:US
Mailing Address - Phone:402-202-5412
Mailing Address - Fax:
Practice Address - Street 1:621 S 45TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-3702
Practice Address - Country:US
Practice Address - Phone:402-202-5412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112071363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care