Healthcare Provider Details

I. General information

NPI: 1952957102
Provider Name (Legal Business Name): CECELIA RAE OPELA-SIERKS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2019
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W LEOTA ST
NORTH PLATTE NE
69101-6525
US

IV. Provider business mailing address

36 COUNTY ROAD 65
STAPLETON NE
69163-5309
US

V. Phone/Fax

Practice location:
  • Phone: 308-568-8000
  • Fax:
Mailing address:
  • Phone: 308-636-8324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number112798
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: