Individual
MARY LONDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6910 PACIFIC ST STE 100, OMAHA, NE 68106-1044
(402) 504-3707
Mailing address
5245 NW 12TH ST APT 510, LINCOLN, NE 68521-4264
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/28/2021
Last updated
02/28/2021
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