Provider Demographics
NPI:1982770004
Name:LOKER, MARY LINDA (CRNA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:LINDA
Last Name:LOKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 S 70TH ST
Mailing Address - Street 2:LINCOLN SURIGICAL HOSPITAL
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1676
Mailing Address - Country:US
Mailing Address - Phone:402-484-9090
Mailing Address - Fax:402-483-0476
Practice Address - Street 1:1710 S 70TH ST
Practice Address - Street 2:LINCOLN SURIGICAL HOSPITAL
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1676
Practice Address - Country:US
Practice Address - Phone:402-484-9090
Practice Address - Fax:402-483-0476
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE100469367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47080732400Medicaid
NE280127Medicare ID - Type Unspecified
NECK6618Medicare PIN
NE430078235Medicare PIN