Provider Demographics
NPI:1740080779
Name:TLAMKA, LACEY RAE
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:RAE
Last Name:TLAMKA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2942 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-1527
Mailing Address - Country:US
Mailing Address - Phone:682-717-9303
Mailing Address - Fax:
Practice Address - Street 1:2942 CLINTON ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68503-1527
Practice Address - Country:US
Practice Address - Phone:682-717-9303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist