Basic Information
| Provider Information | |||||||||
| NPI: | 1104083005 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEMHOFF | ||||||||
| FirstName: | SONYA | ||||||||
| MiddleName: | V | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PA-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ROWE | ||||||||
| OtherFirstName: | SONYA | ||||||||
| OtherMiddleName: | V | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PA-C | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2725 S 144TH ST | ||||||||
| Address2: | #110 | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681445243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4026370400 | ||||||||
| FaxNumber: | 4026370400 | ||||||||
| Practice Location | |||||||||
| Address1: | 2725 S 144TH ST | ||||||||
| Address2: | #110 | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681445243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4026370400 | ||||||||
| FaxNumber: | 4026370400 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2008 | ||||||||
| LastUpdateDate: | 12/06/2012 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 1388 | NE | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 001891 | IA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.