Individual
AMBER J WIDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
988095 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8095
(402) 559-9800
(402) 559-9840
Mailing address
11033 CROWN POINT AVE, OMAHA, NE 68164-1507
(402) 496-6559
(402) 933-6501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1098
NE
Other
Enumeration date
05/12/2006
Last updated
11/06/2008
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