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General NPI Number Information
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NPI Number | 1316206923
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Entity Type | Organization
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Legal Business Name | PLATTE VALLEY WOMENS HEALTHCARE, PC
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Dates
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Enumeration Date | 05/16/2012
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 810 W REID AVE SUITE 4
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6583
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Country | US
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Telephone | 308-534-0090
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Fax | 308-534-0091
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Provider Business Mailing Address
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Address Line | 810 W REID AVE SUITE 4
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6583
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Country | US
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Telephone | 308-534-0090
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Fax | 308-534-0091
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | KELLEY A HASENAUER
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Credential | APRN
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Telephone | 308-534-0090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 18908
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 110460
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License Number State | NE
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