Healthcare Provider Details

I. General information

NPI: 1528496213
Provider Name (Legal Business Name): KATHERINE AGNES YUNGHANS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2013
Last Update Date: 10/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8020 O ST
LINCOLN NE
68510-2561
US

IV. Provider business mailing address

8020 O ST
LINCOLN NE
68510-2561
US

V. Phone/Fax

Practice location:
  • Phone: 402-488-6370
  • Fax: 402-488-4393
Mailing address:
  • Phone: 402-488-6370
  • Fax: 402-488-4393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number85270
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number96158
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2009038610
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number76015
License Number StateKS
# 5
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number120072
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: