Basic Information
| Provider Information | |||||||||
| NPI: | 1619295383 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CANTRELL | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 988102 NEBRAKSA MEDICAL CENTER | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681988102 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | EMILE @ 42ND ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 68198 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025594017 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2010 | ||||||||
| LastUpdateDate: | 04/02/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0102X | 31484 | NE | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 208600000X | TRN14707 | FL | N | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.