Individual
KAITLYN DANIELLE PREMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7500 MERCY RD, OMAHA, NE 68124-2319
(402) 398-6060
Mailing address
7305 ONTARIO ST APT 310, OMAHA, NE 68124-8427
(308) 455-0554
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
121904
IA
363AM0700X
Medical Physician Assistant
Primary
2993
NE
Other
Enumeration date
09/22/2023
Last updated
04/17/2025
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