Healthcare Provider Details

I. General information

NPI: 1326567660
Provider Name (Legal Business Name): MARIA DOUTHETT DNP-APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2017
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 S 26TH AVE
OMAHA NE
68131-3622
US

IV. Provider business mailing address

PO BOX 2797
OMAHA NE
68103-2797
US

V. Phone/Fax

Practice location:
  • Phone: 402-354-3198
  • Fax:
Mailing address:
  • Phone: 402-354-4230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2015
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: