Individual
SAMANTHA E WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-NP
Contact information
Practice address
EMILE @ 42ND ST, OMAHA, NE 68198-0001
(402) 559-0692
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
112801
NE
Other
Enumeration date
07/15/2019
Last updated
05/13/2020
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