Individual
DATE AMOUZOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
16101 GREBE ST, BENNINGTON, NE 68007-1255
(402) 517-0839
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
112098
NE
Other
Enumeration date
08/19/2016
Last updated
05/27/2021
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