Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 11014 | NE |
NPI | 1003927096 |
---|---|
Provider Name | Mary K Meagher |
First Address | Omaha, NE 68178-0001 |
Second Address | Omaha, NE 68107-1764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |