Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 112190 | NE |
N | 363LA2200X | Nurse Practitioner - Adult Health | 112190 | NE |
N | 363LG0600X | Nurse Practitioner - Gerontology | 112190 | NE |
NPI | 1053852848 |
---|---|
Provider Name | Tonya Mcleay |
First Address | Omaha, NE 68198-8102 |
Second Address | Omaha, NE 68105-1107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2017 |
Last Update Date | 16/06/2017 |