Healthcare Provider Details

I. General information

NPI: 1558701763
Provider Name (Legal Business Name): KATRINA CELESTE JAMAL MSN, APRN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2013
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 DODGE ST
OMAHA NE
68114-4113
US

IV. Provider business mailing address

1022 WOODBURY AVE
COUNCIL BLUFFS IA
51503-7915
US

V. Phone/Fax

Practice location:
  • Phone: 712-352-0405
  • Fax: 712-352-0356
Mailing address:
  • Phone: 712-352-0405
  • Fax: 712-352-0356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number111519
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberC176958
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number111519
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: