Healthcare Provider Details

I. General information

NPI: 1659157204
Provider Name (Legal Business Name): KATHRYN NICOLE ORTGIES PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2023
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 S 144TH ST STE 212
OMAHA NE
68144-5253
US

IV. Provider business mailing address

2725 S 144TH ST STE 212
OMAHA NE
68144-5253
US

V. Phone/Fax

Practice location:
  • Phone: 402-609-3000
  • Fax: 402-609-3808
Mailing address:
  • Phone: 402-609-3000
  • Fax: 402-609-3808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2992
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: