Healthcare Provider Details

I. General information

NPI: 1710539820
Provider Name (Legal Business Name): ANNA ELIZABETH NOVAK APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N 2ND ST
ONEILL NE
68763-1514
US

IV. Provider business mailing address

300 N 2ND ST
ONEILL NE
68763-1514
US

V. Phone/Fax

Practice location:
  • Phone: 402-336-2900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number76925
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number112941
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: