=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225621493
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARIN ASHLEY NURSE PRACTITIONER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2021
-----------------------------------------------------
Last Update Date | 07/09/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 118 23RD ST # 189
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68601-2780
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-302-2082
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 118 23RD ST # 189
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68601-2780
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-302-2082
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number | 112327
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------