Individual
AZRA EMILY BAUMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8303 DODGE ST, OMAHA, NE 68114-4108
(402) 354-4424
(402) 354-4435
Mailing address
PO BOX 2797, OMAHA, NE 68103-2797
(402) 354-4230
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2055
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952683674
—
IA
05
—
47037660412
—
NE
Enumeration date
09/20/2011
Last updated
11/21/2016
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