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1861060238
AUDREY C GUSTAFSON
OMAHA, NE
NPI
1861060238
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: NE 2620)
Enumeration Date
2021-06-14
Last Update Date
2021-06-14
Business Address
AUDREY C GUSTAFSON PA-C
8200 DODGE ST
OMAHA, NE 68114-4113
Phone number: 402-955-7400
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Mailing Address
AUDREY C GUSTAFSON PA-C
PO BOX 24607
OMAHA, NE 68124-0607
Phone number: 402-955-5400
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