Individual
LAURA A CERONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8303 DODGE ST, OMAHA, NE 68114-4108
(402) 354-3152
(402) 354-8720
Mailing address
PO BOX 2797, OMAHA, NE 68103-2797
(402) 354-4230
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1519
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497073126
WELLMARK
IA
05
—
470376604-04
—
NE
Enumeration date
05/05/2010
Last updated
12/16/2013
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