Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 2005-0329 | NM |
N | 208600000X | Surgeon | 2005-0329 | NM |
N | 208200000X | Surgeon | 26792 | NE |
N | 208600000X | Surgeon | 26792 | NE |
N | 208200000X | Surgeon | 7942743-1205 | UT |
N | 208600000X | Surgeon | 7942743-1205 | UT |
Y | 208C00000X | Colorectal Surgeon | 26792 | NE |
NPI | 1013056050 |
---|---|
Provider Name | Kelly Johnson Krier |
First Address | Lincoln, NE 68510-7901 |
Second Address | Lincoln, NE 68510-7901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 15/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10025389300 | (05) | NE |
P01170228 | PALMETTO GBA (01) | NE |