Individual
SAMONE MARIE WULF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3901 PINE LAKE RD STE 120, LINCOLN, NE 68516-5497
(402) 420-1212
(402) 328-0961
Mailing address
3901 PINE LAKE RD STE 120, LINCOLN, NE 68516-5497
(402) 420-3417
(402) 328-0961
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2456
NE
Other
Enumeration date
02/21/2020
Last updated
04/29/2021
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