Provider Demographics
NPI:1447799325
Name:COLETTE WHEELER APRN PC
Entity Type:Organization
Organization Name:COLETTE WHEELER APRN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SELF
Authorized Official - Prefix:
Authorized Official - First Name:COLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:402-202-7273
Mailing Address - Street 1:770 N COTNER BLVD STE 328
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2344
Mailing Address - Country:US
Mailing Address - Phone:402-202-7273
Mailing Address - Fax:402-261-5405
Practice Address - Street 1:770 N COTNER BLVD STE 328
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2377
Practice Address - Country:US
Practice Address - Phone:402-202-7273
Practice Address - Fax:402-261-5405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111358163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026250903Medicaid
NE098935Medicare UPIN