Individual
MALLORY MARIE COOLIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
8141 W CENTER RD STE 200, OMAHA, NE 68124-3273
(402) 717-3000
Mailing address
11461 BAUMAN AVE, OMAHA, NE 68164-6815
(402) 640-5722
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
113809
NE
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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