Provider Demographics
NPI:1265668032
Name:HARRIGER, KEVIN R (APRN)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:R
Last Name:HARRIGER
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 520
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:NE
Mailing Address - Zip Code:69336-0520
Mailing Address - Country:US
Mailing Address - Phone:308-262-1755
Mailing Address - Fax:308-262-0765
Practice Address - Street 1:3210 AVENUE B
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4303
Practice Address - Country:US
Practice Address - Phone:308-630-0800
Practice Address - Fax:308-630-0842
Is Sole Proprietor?:No
Enumeration Date:2009-06-06
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE111020363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098005004Medicare PIN
NE086022002Medicare PIN