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General NPI Number Information
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NPI Number | 1639970312
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Entity Type | Organization
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Legal Business Name | ECUBED CONSULTING LLC
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 14441 DUPONT CT STE 101
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City | OMAHA
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State | NE
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Zip | 68144-2107
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Country | US
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Telephone | 402-830-0338
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Fax |
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Provider Business Mailing Address
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Address Line | 9101 KILPATRICK PKWY
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City | BENNINGTON
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State | NE
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Zip | 68007-3241
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STACEY M SAMUEL
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Credential | PA-C
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Telephone | 503-507-6921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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