Provider Demographics
NPI:1821506593
Name:LANOUE, KRISTY KAY (LPN)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:KAY
Last Name:LANOUE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3144 N 57TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-3443
Mailing Address - Country:US
Mailing Address - Phone:402-709-5524
Mailing Address - Fax:
Practice Address - Street 1:9801 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-1936
Practice Address - Country:US
Practice Address - Phone:402-390-6460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23195164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse