Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 17084 | NE |
NPI | 1003818295 |
---|---|
Provider Name | Camilla Ruth Parson |
First Address | Omaha, NE 68130 |
Second Address | Omaha, NE 68130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 19/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10025058900 | (05) | NE |
10025802200 | (05) | NE |
2944058 | (05) | IA |
E28758 | (02) | |
E28758 | (02) | NE |