Healthcare Provider Details

I. General information

NPI: 1346911781
Provider Name (Legal Business Name): AMARELA OKANOVIC DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2021
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7710 MERCY RD STE 2000
OMAHA NE
68124-2323
US

IV. Provider business mailing address

7261 MERCY RD
OMAHA NE
68124-2311
US

V. Phone/Fax

Practice location:
  • Phone: 402-717-4909
  • Fax: 402-717-6068
Mailing address:
  • Phone: 402-398-6248
  • Fax: 402-829-8513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number113823
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number113823
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: