Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 110929 | NE |
NPI | 1265607436 |
---|---|
Provider Name | Mrs. Elizabeth J Kothenbeutel |
First Address | Omaha, NE 68131-2137 |
Second Address | Omaha, NE 68131-2137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2008 |
Last Update Date | 03/08/2009 |