Healthcare Provider Details

I. General information

NPI: 1558001149
Provider Name (Legal Business Name): PATRICIA BITTERS HOTALING DNP, APRN-CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4111 DEWEY AVE
OMAHA NE
68198-0001
US

IV. Provider business mailing address

19704 PINE ST
OMAHA NE
68130-2997
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-6539
  • Fax:
Mailing address:
  • Phone: 402-681-1310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number70718
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number114142
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: