Individual
JASMINE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1941 S 42ND ST, OMAHA, NE 68105-2982
(402) 459-0346
Mailing address
1941 S 42ND ST, OMAHA, NE 68105-2982
(402) 459-0346
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8133668442
—
NE
Enumeration date
09/21/2016
Last updated
09/21/2016
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