Provider Demographics
NPI:1225445091
Name:CAPRON, KIMBERLY A (APRN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:CAPRON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:SSHMITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17201 WRIGHT ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2042
Mailing Address - Country:US
Mailing Address - Phone:402-334-4773
Mailing Address - Fax:402-330-7463
Practice Address - Street 1:17201 WRIGHT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2042
Practice Address - Country:US
Practice Address - Phone:402-334-4773
Practice Address - Fax:402-330-7463
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111688363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE111688OtherNEBRASKA APRN LICENSE