Provider Demographics
NPI:1679823967
Name:OLTMAN, THERESA (ARNP)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:OLTMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5566 SOUTH 56TH
Mailing Address - Street 2:CVS MINUTE CLINIC
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516
Mailing Address - Country:US
Mailing Address - Phone:402-423-6510
Mailing Address - Fax:
Practice Address - Street 1:5566 SOUTH 56TH
Practice Address - Street 2:CVS MINUTE CLINIC
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516
Practice Address - Country:US
Practice Address - Phone:402-423-6510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA131817363LF0000X
NE111381363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily