Basic Information
Provider Information
NPI: 1760593222
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOSONE
FirstName: NANCY
MiddleName: C
NamePrefix: MS.
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2797
Address2:  
City: OMAHA
State: NE
PostalCode: 681032797
CountryCode: US
TelephoneNumber: 4023544230
FaxNumber: 4023546171
Practice Location
Address1: 8303 DODGE ST
Address2:  
City: OMAHA
State: NE
PostalCode: 681144108
CountryCode: US
TelephoneNumber: 4023544424
FaxNumber: 4023544435
Other Information
ProviderEnumerationDate: 08/31/2006
LastUpdateDate: 12/16/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X110137NEY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

ID Information
IDTypeStateIssuerDescription
4703766041205NE MEDICAID
176059322205IA MEDICAID


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