Healthcare Provider Details

I. General information

NPI: 1306282215
Provider Name (Legal Business Name): AMELA HODZIC ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2013
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 N 190TH PLZ STE 3200
ELKHORN NE
68022-3913
US

IV. Provider business mailing address

PO BOX 3755
OMAHA NE
68103-0755
US

V. Phone/Fax

Practice location:
  • Phone: 402-815-1960
  • Fax: 402-815-1961
Mailing address:
  • Phone: 402-354-2100
  • Fax: 402-354-2155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number111755
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9302429
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: