Provider Demographics
NPI:1871301531
Name:GVOZDIK, LESIA
Entity type:Individual
Prefix:
First Name:LESIA
Middle Name:
Last Name:GVOZDIK
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 1:700 N 57TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2302
Mailing Address - Country:US
Mailing Address - Phone:402-202-3899
Mailing Address - Fax:
Practice Address - Street 1:700 N 57TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2302
Practice Address - Country:US
Practice Address - Phone:402-202-3899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-26
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant