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Individual

MARY COUTURE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
(402) 559-4015
(402) 559-8715
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
(402) 559-4015
(402) 559-8715

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001535
IA
363A00000X
Physician Assistant
Primary
1056
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17293
WELLMARK BCBS
01
242918
MIDLANDS CHOICE
05
6827720
SD
Enumeration date
06/21/2006
Last updated
06/08/2015
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