Jan, Omar
Jan, Omar is an individual health care provider with primary practice located at 4351 E Lohman Ave Ste 301 , Las Cruces NM 88011-8262. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Jan, Omar can be contacted via phone (575) 532-9755.Contact Information
Primary practice address
4351 E Lohman Ave Ste 301
Las Cruces NM 88011-8262
Phone: (575) 532-9755
Fax: (575) 532-8881
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1889 | Wisconsin |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA2005-0019 | New Mexico |
Profile Details
| NPI number | 1376696971 |
|---|---|
| LBN Legal business name | Jan, Omar |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 19th, 2007 |
| Last updated | Nov 15th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376696971 | NPPES |
| Wisconsin | MEDICAID | 1376696971 | |
| Wisconsin | MEDICAID | 588571 |
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