Provider Demographics
NPI:1093196909
Name:DILLON, KERI E (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:E
Last Name:DILLON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12728 AUGUSTA AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3754
Mailing Address - Country:US
Mailing Address - Phone:402-330-1410
Mailing Address - Fax:402-330-4294
Practice Address - Street 1:12728 AUGUSTA AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3754
Practice Address - Country:US
Practice Address - Phone:402-330-1410
Practice Address - Fax:402-330-4294
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111813363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care