Individual
MS. BOBBI LYNN FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PEER SPECIALIST
Contact information
Practice address
415 SOUTH 25TH AVE, ANNEX BLD, OMAHA, NE 68131
(402) 715-4226
Mailing address
4006 IDA ST, ALPHA LIFE, OMAHA, NE 68112-0257
(531) 207-6462
(402) 999-4786
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CPSS-305
NE
376K00000X
Nurse's Aide
52521
NE
Other
Enumeration date
12/05/2018
Last updated
06/06/2024
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