NPI 1003603689

Dominique Merle Mack

Practitioner Physician Assistant Omaha, NE

Practice location

Address: 1813 N 73rd St, Omaha, NE 68114-1905
Phone: (402) 991-5070

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence H14171394 (NE)

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Registry record

NPI: 1003603689
Entity type: Individual
Sex (as registered): Female
NPI issued: 24 Apr 2025
Record last updated: 24 Apr 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.