Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 112386 | NE |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 53-44576 | KS |
N | 363LG0600X | Nurse Practitioner - Gerontology | 53-44576 | KS |
NPI | 1033188321 |
---|---|
Provider Name | Linda Kroeger |
First Address | Lincoln, NE 68526-6700 |
Second Address | Lincoln, NE 68526-6700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 12/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R94986 | (02) | KS |