Healthcare Provider Details

I. General information

NPI: 1518501758
Provider Name (Legal Business Name): BRITTNEY LYNN KOTAS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 10/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 PERRY ST
ODELL NE
68415-0188
US

IV. Provider business mailing address

PO BOX 188
ODELL NE
68415-0188
US

V. Phone/Fax

Practice location:
  • Phone: 402-766-4210
  • Fax: 402-766-4211
Mailing address:
  • Phone: 402-766-4210
  • Fax: 402-766-4211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number69846
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: