Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 110384 | NE |
NPI | 1023170222 |
---|---|
Provider Name | Catherine O'keefe |
First Address | Omaha, NE 68114-3451 |
Second Address | Bellevue, NE 68123-6006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
37708 | BLUE CROSS & BLUE SHIELD (01) | NE |
47068937203 | (05) | NE |