Individual
JULIA MARIE WAGEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1111 N 102ND CT STE 200, OMAHA, NE 68114
(402) 502-2747
(402) 502-2387
Mailing address
1111 N 102ND CT STE 200, OMAHA, NE 68114-2194
(402) 502-2747
(402) 502-2387
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
40320
NE
163WN0300X
Nephrology Registered Nurse
40320
NE
174400000X
Specialist
40320
NE
363L00000X
Nurse Practitioner
Primary
110314
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0993865
—
IA
Enumeration date
09/20/2006
Last updated
03/14/2019
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