Healthcare Provider Details

I. General information

NPI: 1073113676
Provider Name (Legal Business Name): JULIE OBENAUER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2020
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7312 N 30TH ST
OMAHA NE
68112-2821
US

IV. Provider business mailing address

2215 HOWARD ST APT 408
OMAHA NE
68102-2444
US

V. Phone/Fax

Practice location:
  • Phone: 402-451-3980
  • Fax:
Mailing address:
  • Phone: 716-548-4446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH030183
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number071791
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18686
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: