Healthcare Provider Details

I. General information

NPI: 1487061529
Provider Name (Legal Business Name): NATALIE DAWN OMMEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 11/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 WOOLWORTH AVE
OMAHA NE
68105-1850
US

IV. Provider business mailing address

1802 S FILLMORE ST
PAPILLION NE
68046-4198
US

V. Phone/Fax

Practice location:
  • Phone: 800-451-5796
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7273
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: