Provider Demographics
NPI:1760407274
Name:WOMENS CLINIC OF LINCOLN PC
Entity Type:Organization
Organization Name:WOMENS CLINIC OF LINCOLN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-434-3370
Mailing Address - Street 1:220 LYNCREST DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510
Mailing Address - Country:US
Mailing Address - Phone:402-434-3370
Mailing Address - Fax:402-489-0731
Practice Address - Street 1:220 LYNCREST DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510
Practice Address - Country:US
Practice Address - Phone:402-434-3370
Practice Address - Fax:402-489-0731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE01965OtherBLUE CROSS
NE=========13Medicaid
NE=========13Medicaid