Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 28463 | NE |
Y | 207ND0900X | Dermatopathologist | 28463 | NE |
NPI | 1134431133 |
---|---|
Provider Name | Dr. Sara Elizabeth West |
First Address | Omaha, NE 68114-2497 |
Second Address | Omaha, NE 68114-2497 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2010 |
Last Update Date | 29/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10025555000 | (05) | NE |