Provider Demographics
NPI:1659157204
Name:ORTGIES, KATHRYN NICOLE (PA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:NICOLE
Last Name:ORTGIES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7512 N 130TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68142-1320
Mailing Address - Country:US
Mailing Address - Phone:402-301-3839
Mailing Address - Fax:
Practice Address - Street 1:701 PINNACLE DR STE 105
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-6228
Practice Address - Country:US
Practice Address - Phone:402-505-7989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant