Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 330 | NE |
NPI | 1003959024 |
---|---|
Provider Name | Judith Ann Scott |
First Address | Omaha, NE 68103-0755 |
Second Address | Elkhorn, NE 68022-3917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 30/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10026301600 | (05) | NE |
1003959024 | (05) | IA |
47068731799 | (05) | NE |