=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740132695
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MCKENNA COOGAN RN, BSN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2026
-----------------------------------------------------
Last Update Date | 02/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11221 NORTHRIDGE DR
-----------------------------------------------------
City | GRETNA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68028-6935
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-332-5578
-----------------------------------------------------
Fax | 402-408-2539
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2411 N 168TH AVE
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68116-2673
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-332-5578
-----------------------------------------------------
Fax | 402-408-2539
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WS0200X
-----------------------------------------------------
Taxonomy Name | School Registered Nurse
-----------------------------------------------------
License Number | 93713
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------