Provider Demographics
NPI:1649985391
Name:RECKART, GRACE ANNE (LVN)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:ANNE
Last Name:RECKART
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 5TH CORSO
Mailing Address - Street 2:
Mailing Address - City:NEBRASKA CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68410-2610
Mailing Address - Country:US
Mailing Address - Phone:737-222-3536
Mailing Address - Fax:
Practice Address - Street 1:2231 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-3907
Practice Address - Country:US
Practice Address - Phone:402-291-1203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX350180164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse