Provider Demographics
NPI:1689905754
Name:LINDBERG, JANIS M (RN)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:M
Last Name:LINDBERG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 E 10TH ST
Mailing Address - Street 2:P O BOX 187
Mailing Address - City:SUPERIOR
Mailing Address - State:NE
Mailing Address - Zip Code:68978-1225
Mailing Address - Country:US
Mailing Address - Phone:402-879-3281
Mailing Address - Fax:402-879-3401
Practice Address - Street 1:520 E 10TH ST
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:NE
Practice Address - Zip Code:68978-1225
Practice Address - Country:US
Practice Address - Phone:402-879-3281
Practice Address - Fax:402-879-3401
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE38466133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE059OtherBLUE CROSS BLUE SHIELD NE