Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 113777 | NE |
NPI | 1003576406 |
---|---|
Provider Name | Kate Patricia Horn |
First Address | Omaha, NE 68106-3460 |
Second Address | Omaha, NE 68135-1380 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2021 |
Last Update Date | 27/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
113777 | APRN LICENSE (01) | NE |