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1629734751
MALLORY MARIE COOLIDGE
OMAHA, NE
NPI
1629734751
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Former Name
MALLORY MARIE WEAVER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: NE 113809)
Enumeration Date
2021-11-12
Last Update Date
2021-11-12
Business Address
MALLORY MARIE COOLIDGE APRN
8141 W CENTER RD STE 200
OMAHA, NE 68124-3273
Phone number: 402-717-3000
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Mailing Address
MALLORY MARIE COOLIDGE APRN
11461 BAUMAN AVE
OMAHA, NE 68164-6815
Phone number: 402-640-5722
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