Individual
SAMANTHA ELLEN PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5200 S 56TH ST STE 2, LINCOLN, NE 68516-1891
(402) 421-6200
(402) 421-6070
Mailing address
5200 S 56TH ST STE 2, LINCOLN, NE 68516-1891
(402) 421-6200
(402) 421-6070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2565
NE
363AM0700X
Medical Physician Assistant
Primary
2565
NE
Other
Enumeration date
08/17/2021
Last updated
09/01/2022
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