Healthcare Provider Details

I. General information

NPI: 1679052823
Provider Name (Legal Business Name): EMILY MARIE ZMIJEWSKI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2018
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17201 WRIGHT STREET SUITE 200
OMAHA NE
68130
US

IV. Provider business mailing address

17201 WRIGHT STREET SUITE 200
OMAHA NE
68130
US

V. Phone/Fax

Practice location:
  • Phone: 402-334-4773
  • Fax: 402-330-7463
Mailing address:
  • Phone: 402-334-4773
  • Fax: 402-330-7463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2503
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: