Healthcare Provider Details

I. General information

NPI: 1730688714
Provider Name (Legal Business Name): KATHLEEN MORGAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHLEEN KLIKA RN

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 02/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 0 S 41ST
LINCOLN NE
68516
US

IV. Provider business mailing address

611 0 S 41ST
LINCOLN NE
68516
US

V. Phone/Fax

Practice location:
  • Phone: 402-613-4518
  • Fax:
Mailing address:
  • Phone: 402-613-4518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number55619
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: