Provider Demographics
NPI:1679371975
Name:BOUKAL, LAUREN LYNN
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:LYNN
Last Name:BOUKAL
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 1:4611 S 96TH ST STE 292
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1256
Mailing Address - Country:US
Mailing Address - Phone:531-375-0895
Mailing Address - Fax:
Practice Address - Street 1:4611 S 96TH ST STE 292
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1256
Practice Address - Country:US
Practice Address - Phone:531-375-0895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant