Provider Demographics
NPI:1598642787
Name:MINNEMA, LORA
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:
Last Name:MINNEMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 S BOSTON AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-5725
Mailing Address - Country:US
Mailing Address - Phone:386-273-5617
Mailing Address - Fax:386-273-5617
Practice Address - Street 1:225 N WEBB RD STE 3
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4041
Practice Address - Country:US
Practice Address - Phone:402-742-0311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist