Provider Demographics
NPI:1275220949
Name:KATECARES TELEMEDICINE LLC
Entity Type:Organization
Organization Name:KATECARES TELEMEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NP
Authorized Official - Prefix:
Authorized Official - First Name:KATIEVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSH-WILKS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:402-219-4633
Mailing Address - Street 1:5309 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-5301
Mailing Address - Country:US
Mailing Address - Phone:402-219-4633
Mailing Address - Fax:
Practice Address - Street 1:5309 NW 3RD ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-5301
Practice Address - Country:US
Practice Address - Phone:402-219-4633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service