Provider Demographics
NPI:1750655619
Name:WEHNER, NANCY L (BS, RDH, OM)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:L
Last Name:WEHNER
Suffix:
Gender:F
Credentials:BS, RDH, OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11850 NICHOLAS ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4476
Mailing Address - Country:US
Mailing Address - Phone:402-677-3917
Mailing Address - Fax:
Practice Address - Street 1:11850 NICHOLAS ST
Practice Address - Street 2:SUITE 130
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4476
Practice Address - Country:US
Practice Address - Phone:402-677-3917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE283124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist