Individual
CALLISTA LEE KOMASINCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4239 FARNAM ST STE 100, OMAHA, NE 68131-2858
(402) 552-2320
(402) 552-2330
Mailing address
4239 FARNAM ST STE 100, OMAHA, NE 68131-2858
(402) 552-2320
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
112970
NE
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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