Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 1356 | NE |
Y | 152W00000X | Optometrist | 14107 | CA |
NPI | 1013295252 |
---|---|
Provider Name | Courtney A Kness |
First Address | Holdrege, NE 68949-4052 |
Second Address | Holdrege, NE 68949-2052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2011 |
Last Update Date | 17/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
47061665413 | (05) | NE |