Individual
TARA CALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
139 S 40TH ST, OMAHA, NE 68131
(402) 595-3939
(402) 595-3898
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1870
NE
Other
Enumeration date
12/09/2014
Last updated
06/27/2018
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