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Individual

SUSAN K EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
EMILE 42ND ST, OMAHA, NE 68198-0001
(402) 559-7200
(402) 559-9344
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
(402) 559-6195

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25052
NE
207Q00000X
Family Medicine Physician
49321
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025464000
NE
05
1548459159
IA
Enumeration date
10/19/2007
Last updated
07/19/2016
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