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NPI Code Detail

MEDICARE: DR. KATHERINE JANE ROBERTSON M.D.

MEDICARE: DR. KATHERINE JANE ROBERTSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician27965NE

General Provider Information

NPI Number : 1528313699
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHERINE JANE ROBERTSON M.D.
Provider Business Mailing Address
First Line : 4001 LEAVENWORTH ST
Second Line :
City : OMAHA
State : NE
Zip : 68105-1026
Country : US
Telephone Number : 402-341-5128
Fax Number : 402-341-2992
Provider Business Practice Location Address
First Line : 4001 LEAVENWORTH ST
Second Line :
City : OMAHA
State : NE
Zip : 68105-1026
Country : US
Telephone Number : 402-341-5128
Fax Number : 402-341-2992
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2012
Last Update Date : 02/03/2017

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