Provider Demographics
NPI:1407466949
Name:VAN GESTEL, CATHERINE ANN (RN, BSN, IBCLC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:VAN GESTEL
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17129 BARNETT ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-3018
Mailing Address - Country:US
Mailing Address - Phone:402-850-6345
Mailing Address - Fax:
Practice Address - Street 1:16410 FOWLER AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-3245
Practice Address - Country:US
Practice Address - Phone:402-250-2668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE74335163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant