Provider Demographics
NPI:1700699345
Name:TADROS, AMAL BUSHRA
Entity type:Individual
Prefix:
First Name:AMAL
Middle Name:BUSHRA
Last Name:TADROS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4780 S 131ST ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-1822
Mailing Address - Country:US
Mailing Address - Phone:402-546-1870
Mailing Address - Fax:
Practice Address - Street 1:2507 S 105TH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-1825
Practice Address - Country:US
Practice Address - Phone:402-972-6898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion