Individual
MRS. JOANN MARIE MEDEIROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3109 PEDERSEN DR, OMAHA, NE 68144-3912
(531) 299-7802
Mailing address
3109 PEDERSEN DR, OMAHA, NE 68144-3912
(531) 299-7802
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
41356
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41356
NURSING LICENSE
NE
Enumeration date
09/19/2018
Last updated
09/19/2018
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