Provider Demographics
NPI:1942661970
Name:INDEPENDENT HOLISTIC OUTPATIENT PSYCHIATRY & EMPOWERMENT
Entity Type:Organization
Organization Name:INDEPENDENT HOLISTIC OUTPATIENT PSYCHIATRY & EMPOWERMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:402-200-9778
Mailing Address - Street 1:301 S 70TH ST
Mailing Address - Street 2:SUITE 355E
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2469
Mailing Address - Country:US
Mailing Address - Phone:402-200-9778
Mailing Address - Fax:
Practice Address - Street 1:301 S 70TH ST
Practice Address - Street 2:SUITE 355E
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2469
Practice Address - Country:US
Practice Address - Phone:402-200-9778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111792363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty