Provider Demographics
NPI:1225815806
Name:SOUMANA HAMA, RASILA (APRN)
Entity Type:Individual
Prefix:
First Name:RASILA
Middle Name:
Last Name:SOUMANA HAMA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:NA
Other - Middle Name:
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8629 S 163RD AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68136-1450
Mailing Address - Country:US
Mailing Address - Phone:402-216-5468
Mailing Address - Fax:
Practice Address - Street 1:4014 LEAVENWORTH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-1026
Practice Address - Country:US
Practice Address - Phone:402-559-4292
Practice Address - Fax:402-559-6529
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE114962363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care