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Individual

MRS. AIMEE M PROBASCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
11946 STANDING STONE DR, GRETNA, NE 68028-8094
(402) 815-4500
(402) 815-4510
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
1245
NE
207VH0002X
Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
5512
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10026301600
NE
05
10026480100
NE
05
1508085929
IA
05
47068731799
NE
Enumeration date
04/24/2007
Last updated
07/15/2015
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