Provider Demographics
NPI:1326242405
Name:HONZ, KATHRYN (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:HONZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3755
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-0755
Mailing Address - Country:US
Mailing Address - Phone:402-354-2100
Mailing Address - Fax:402-354-2155
Practice Address - Street 1:717 N 190TH PLZ
Practice Address - Street 2:STE 2200
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-3984
Practice Address - Country:US
Practice Address - Phone:402-815-2300
Practice Address - Fax:402-815-1045
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE26503208200000X
AZ77160208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026293200Medicaid
IA1326242405Medicaid
NE10025715000Medicaid
MT10026480112Medicaid
NE10025715000Medicaid