Individual
SA MI NAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5815 TAYLOR ST, OMAHA, NE 68104-2744
(402) 800-6017
Mailing address
5815 TAYLOR ST, OMAHA, NE 68104-2744
(402) 800-6017
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
NE
Other
Enumeration date
03/14/2025
Last updated
03/14/2025
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