Provider Demographics
NPI:1477270122
Name:LNK WELLNESS CARE AND AESTHETICS
Entity Type:Organization
Organization Name:LNK WELLNESS CARE AND AESTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN-NP
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALES
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:531-530-0328
Mailing Address - Street 1:1001 S 70TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-7901
Mailing Address - Country:US
Mailing Address - Phone:531-530-0328
Mailing Address - Fax:
Practice Address - Street 1:1001 S 70TH ST STE 105
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-7901
Practice Address - Country:US
Practice Address - Phone:531-530-0328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1467054569Medicaid