Healthcare Provider Details

I. General information

NPI: 1518086271
Provider Name (Legal Business Name): KATHY S KING APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N 30TH ST
OMAHA NE
68131-2137
US

IV. Provider business mailing address

1013 N NYE AVE
FREMONT NE
68025-4058
US

V. Phone/Fax

Practice location:
  • Phone: 402-449-5131
  • Fax:
Mailing address:
  • Phone: 402-721-6914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number110058
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number33492
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: