Individual
NICOLE ASCANIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4909 S 118TH ST, OMAHA, NE 68137-2213
(704) 746-5674
Mailing address
4909 S 118TH ST, OMAHA, NE 68137-2213
(704) 746-5674
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10441
SD
207Q00000X
Family Medicine Physician
Primary
30816
NE
Other
Enumeration date
05/03/2013
Last updated
11/28/2020
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