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General NPI Number Information
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NPI Number | 1457643165
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Entity Type | Individual
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Provider Name | KRISTIE DAWN EARSOM PLMHP NCC
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Gender | Female
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Dates
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Enumeration Date | 05/12/2011
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Last Update Date | 05/12/2011
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Provider Practice Location Address
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Address Line | 10730 737 RD
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City | LOOMIS
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State | NE
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Zip | 68958-5806
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Country | US
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Telephone | 308-876-2327
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Fax | 308-876-2130
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Provider Business Mailing Address
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Address Line | 710 BURLINGTON ST
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City | HOLDREGE
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State | NE
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Zip | 68949-2177
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Country | US
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Telephone | 308-995-6691
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Fax | 308-995-6830
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 9323
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9323
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License Number State | NE
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