Basic Information
| Provider Information | |||||||||
| NPI: | 1689690059 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOLAN | ||||||||
| FirstName: | VICKIE | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8111 DODGE ST | ||||||||
| Address2: | SUITE 363 | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681144129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023548155 | ||||||||
| FaxNumber: | 4023548159 | ||||||||
| Practice Location | |||||||||
| Address1: | 8111 DODGE ST | ||||||||
| Address2: | SUITE 363 | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681144129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023548155 | ||||||||
| FaxNumber: | 4023548159 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 363LA2100X | 1766 | NE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.