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General NPI Number Information
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NPI Number | 1427245968
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Entity Type | Individual
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Provider Name | NELIDA CARIDAD REYES OLIVA PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/28/2007
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Last Update Date | 09/15/2015
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Provider Practice Location Address
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Address Line | 1411 SUPERIOR STREET MINUTE CLINIC INSIDE CVS PHARMACY
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City | LINCOLN
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State | NE
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Zip | 68504
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Country | US
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Telephone | 188-838-9272
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Fax |
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Provider Business Mailing Address
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Address Line | 6040 MERIDIAN DR APT 45
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City | LINCOLN
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State | NE
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Zip | 68504-4404
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Country | US
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Telephone | 315-528-2415
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1338
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License Number State | NE
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