Provider Demographics
NPI:1023206281
Name:ONNEN, NATHAN SCOTT (PHARM D)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:SCOTT
Last Name:ONNEN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 ROAD 5000
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:NE
Mailing Address - Zip Code:68335-3029
Mailing Address - Country:US
Mailing Address - Phone:402-364-3106
Mailing Address - Fax:
Practice Address - Street 1:2220 ROAD 5000
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:NE
Practice Address - Zip Code:68335-3029
Practice Address - Country:US
Practice Address - Phone:402-364-3106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12658183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist