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Individual

PETRISOR TUDOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP-BC, APRN, MSN

Contact information

Practice address
11404 W DODGE RD STE 300, OMAHA, NE 68154-2511
(402) 898-1113
(402) 819-5588
Mailing address
421 S 243RD ST, WATERLOO, NE 68069-4704
(402) 417-2524
(402) 465-8717

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
114357
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10026632500
NE
Enumeration date
09/14/2022
Last updated
10/30/2025
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