Provider Demographics
NPI:1972021228
Name:AMEN, MARY BETH (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:BETH
Last Name:AMEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 O ST STE 3
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-1100
Mailing Address - Country:US
Mailing Address - Phone:402-817-0165
Mailing Address - Fax:402-417-0255
Practice Address - Street 1:2301 O ST STE 3
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1100
Practice Address - Country:US
Practice Address - Phone:402-817-0165
Practice Address - Fax:402-417-0255
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE105891835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric