Provider Demographics
NPI:1205165230
Name:HOMAN, NINA DEARMONT (PHARM D)
Entity type:Individual
Prefix:DR
First Name:NINA
Middle Name:DEARMONT
Last Name:HOMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22220 GILES ROAD
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028
Mailing Address - Country:US
Mailing Address - Phone:402-332-3429
Mailing Address - Fax:
Practice Address - Street 1:10004 SOUTH 152ND ST.
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68138
Practice Address - Country:US
Practice Address - Phone:402-861-4939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist