Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 112278 | NE |
NPI | 1043734973 |
---|---|
Provider Name | Abby J Mckeon |
First Address | Omaha, NE 68114-4113 |
Second Address | Omaha, NE 68114-4113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2017 |
Last Update Date | 02/08/2017 |