Healthcare Provider Details

I. General information

NPI: 1609976224
Provider Name (Legal Business Name): HEATHER A OTHMER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER A WARMAN

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 07/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 VILLAGE SQ
GRETNA NE
68028-7914
US

IV. Provider business mailing address

818 VILLAGE SQ P.O. BOX 527
GRETNA NE
68028-7914
US

V. Phone/Fax

Practice location:
  • Phone: 402-332-4559
  • Fax: 402-332-4598
Mailing address:
  • Phone: 402-332-4559
  • Fax: 402-332-4598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number110692
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: