Healthcare Provider Details

I. General information

NPI: 1346761053
Provider Name (Legal Business Name): EWONUBARI KEHINDE EREKERE KATS RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 07/21/2022
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S. 70TH STREET 104
LINCOLN NE
68506
US

IV. Provider business mailing address

1500 S 70TH ST STE 102
LINCOLN NE
68506-1574
US

V. Phone/Fax

Practice location:
  • Phone: 402-387-7933
  • Fax: 402-809-8017
Mailing address:
  • Phone: 402-387-7933
  • Fax: 402-809-8017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number75882
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number113989
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: