Provider Demographics
NPI:1912715947
Name:DAO, SANDY (PA-C)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:DAO
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8141 W CENTER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3273
Mailing Address - Country:US
Mailing Address - Phone:402-717-3000
Mailing Address - Fax:
Practice Address - Street 1:8141 W CENTER RD STE 200
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3273
Practice Address - Country:US
Practice Address - Phone:402-717-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA130134363A00000X
NE363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant