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NPI Code Detail

MEDICARE: ERIN N KOPIETZ APRN

MEDICARE: ERIN N KOPIETZ APRN
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
1363L00000XNurse Practitioner111165NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
147024OTHERNEBCBS NE

General Provider Information

NPI Number : 1619288222
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN N KOPIETZ APRN
Provider Business Mailing Address
First Line : 3901 PINE LAKE RD
Second Line : SUITE 211
City : LINCOLN
State : NE
Zip : 68516-5497
Country : US
Telephone Number : 402-423-4200
Fax Number : 402-423-4201
Provider Business Practice Location Address
First Line : 211 S 23RD ST
Second Line : INSIDE PAMIDA
City : PLATTSMOUTH
State : NE
Zip : 68048-2903
Country : US
Telephone Number : 402-296-5100
Fax Number : 402-296-5107
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2010
Last Update Date : 11/09/2010

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Directions to “ ERIN N KOPIETZ APRN” Practice Location

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