Healthcare Provider Details

I. General information

NPI: 1891402251
Provider Name (Legal Business Name): KATIE SEACREST APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2022
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 S 16TH ST # 400
LINCOLN NE
68502-3796
US

IV. Provider business mailing address

2724 JACKSON DR
LINCOLN NE
68502-5032
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-8590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number114497
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: