Healthcare Provider Details

I. General information

NPI: 1215210265
Provider Name (Legal Business Name): BRANDI ROSE OLMER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 SUPERIOR ST
LINCOLN NE
68521-1945
US

IV. Provider business mailing address

3123 FLETCHER AVE APT 245
LINCOLN NE
68504-1042
US

V. Phone/Fax

Practice location:
  • Phone: 402-477-2622
  • Fax:
Mailing address:
  • Phone: 402-546-6596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number50796
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13786
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: