Healthcare Provider Details

I. General information

NPI: 1558148411
Provider Name (Legal Business Name): GENA POPKEN DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2023
Last Update Date: 09/13/2023
Certification Date: 09/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W NORFOLK AVE
NORFOLK NE
68701-4438
US

IV. Provider business mailing address

640 HILLCREST RD
WEST POINT NE
68788-1104
US

V. Phone/Fax

Practice location:
  • Phone: 402-371-4880
  • Fax:
Mailing address:
  • Phone: 402-719-0946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number115002
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: