Provider Demographics
NPI:1104043850
Name:KLAPATCH, KRISTEN (OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:KLAPATCH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ELIZABETH
Other - Last Name:HASSELTINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:5321 S 138TH STREET
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137
Mailing Address - Country:US
Mailing Address - Phone:402-895-4000
Mailing Address - Fax:
Practice Address - Street 1:5321 S 138TH STREET
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137
Practice Address - Country:US
Practice Address - Phone:402-895-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2015-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119003967225X00000X
NE1812225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004979907Medicaid
VA004979907Medicaid