Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 28777 | NE |
N | 2086X0206X | Surgical Oncologist | P6602 | TX |
NPI | 1144467291 |
---|---|
Provider Name | Dr. Nicole De Rosa |
First Address | Omaha, NE 68198-8102 |
Second Address | Omaha, NE 68198-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2009 |
Last Update Date | 11/02/2016 |