Healthcare Provider Details

I. General information

NPI: 1891085031
Provider Name (Legal Business Name): KATARZYNA MARIA WOLANIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 03/17/2018
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

516 W LEOTA ST
NORTH PLATTE NE
69101
US

V. Phone/Fax

Practice location:
  • Phone: 308-568-8000
  • Fax:
Mailing address:
  • Phone: 308-568-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number30089
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: