Provider Demographics
NPI:1689224529
Name:NADRCHAL, KATLIN (PA-C)
Entity Type:Individual
Prefix:
First Name:KATLIN
Middle Name:
Last Name:NADRCHAL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:754 GOLD COAST DR STE 105
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4498
Mailing Address - Country:US
Mailing Address - Phone:402-201-2300
Mailing Address - Fax:402-201-2307
Practice Address - Street 1:754 GOLD COAST DR STE 105
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4498
Practice Address - Country:US
Practice Address - Phone:402-201-2300
Practice Address - Fax:402-201-2307
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2399207Q00000X
NE363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine