Healthcare Provider Details

I. General information

NPI: 1477724417
Provider Name (Legal Business Name): DENISE L. POLLARD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17525 GOLD PLAZA STE 116
OMAHA NE
68130
US

IV. Provider business mailing address

17525 GOLD PLAZA STE 116
OMAHA NE
68130
US

V. Phone/Fax

Practice location:
  • Phone: 402-937-0101
  • Fax: 402-939-0667
Mailing address:
  • Phone: 402-937-0101
  • Fax: 402-939-0667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number110932
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: