Provider Demographics
NPI:1144203316
Name:PETERS SETTJE, KATIE L (APRN)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:L
Last Name:PETERS SETTJE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:L
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:729 N CUSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4311
Mailing Address - Country:US
Mailing Address - Phone:308-382-9266
Mailing Address - Fax:308-382-5290
Practice Address - Street 1:729 N CUSTER AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4311
Practice Address - Country:US
Practice Address - Phone:308-382-9266
Practice Address - Fax:308-382-5290
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110600363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE277189Medicare ID - Type Unspecified
NEQ01019Medicare UPIN