Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 32543 | NE |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 4129055 | IL |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 56390 | MN |
NPI | 1285945113 |
---|---|
Provider Name | Niyada Naksuk |
First Address | Omaha, NE 68198-8102 |
Second Address | Omaha, NE 68198-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2010 |
Last Update Date | 03/12/2020 |