Healthcare Provider Details

I. General information

NPI: 1164343612
Provider Name (Legal Business Name): SYED SHOAIB QADRI APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2808 N 75TH ST
OMAHA NE
68134-6817
US

IV. Provider business mailing address

2808 N 75TH ST STE H
OMAHA NE
68134-6817
US

V. Phone/Fax

Practice location:
  • Phone: 402-932-2248
  • Fax:
Mailing address:
  • Phone: 402-932-2248
  • Fax: 402-932-3557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number117076
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: