Provider Demographics
NPI:1760159636
Name:DANCZAK, LAWRENCE (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:DANCZAK
Suffix:
Gender:M
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 SHERRY DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-2230
Mailing Address - Country:US
Mailing Address - Phone:308-379-0615
Mailing Address - Fax:
Practice Address - Street 1:710 S 17TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-3108
Practice Address - Country:US
Practice Address - Phone:402-440-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE113587363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health