Healthcare Provider Details

I. General information

NPI: 1922923325
Provider Name (Legal Business Name): SAMIRA ABDUL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3808 TWIN CREEK DR
BELLEVUE NE
68123-4163
US

IV. Provider business mailing address

5513 NW RADIAL HWY APT 1
OMAHA NE
68104-3588
US

V. Phone/Fax

Practice location:
  • Phone: 402-291-6747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19080
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS70759
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: