Individual
ANDREA M PREVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4242 FARNAM ST, SUITE 145, OMAHA, NE 68131-2806
(402) 552-2100
(402) 552-2104
Mailing address
4242 FARNAM ST, SUITE 145, OMAHA, NE 68131-2806
(402) 552-2100
(402) 552-2104
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
129
NE
207RI0200X
Infectious Disease Physician
3311
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00319
BCBS NE
NE
05
—
47081309213
—
NE
05
—
528174
—
IA
05
—
7709822
—
SD
Enumeration date
05/03/2006
Last updated
02/08/2008
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