Individual
MRS. MARNIE ELIZBETH JEAN DELLUTRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10707 PACIFIC ST, SUITE 101, OMAHA, NE 68114-4762
(402) 397-7989
(402) 393-7554
Mailing address
PO BOX 8577, OMAHA, NE 68108-0577
(402) 397-7989
(402) 393-7554
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
1728
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47077934913
—
NE
Enumeration date
05/03/2013
Last updated
01/15/2020
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