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General NPI Number Information
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NPI Number | 1669160743
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Entity Type | Individual
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Provider Name | KJIRSTEN R ERVI RN
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Gender | Female
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Dates
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Enumeration Date | 04/27/2023
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 5908 S 142ND ST
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City | OMAHA
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State | NE
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Zip | 68137-2800
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Country | US
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Telephone | 402-354-1900
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Fax | 402-354-1910
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Provider Business Mailing Address
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Address Line | 825 S 169TH ST FL 3
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City | OMAHA
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State | NE
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Zip | 68118-9300
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Country | US
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Telephone | 402-354-4822
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 80264
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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 | A176479
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 115483
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License Number State | NE
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