Provider Demographics
NPI:1730298779
Name:DAVIS, KATHERINE E (ARNP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:DAVIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 O ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:NE
Mailing Address - Zip Code:68818-1100
Mailing Address - Country:US
Mailing Address - Phone:402-694-3191
Mailing Address - Fax:402-694-2146
Practice Address - Street 1:609 O ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:NE
Practice Address - Zip Code:68818-1100
Practice Address - Country:US
Practice Address - Phone:402-694-3191
Practice Address - Fax:402-694-2146
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110113363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE267044Medicare ID - Type UnspecifiedMEDICARE NUMBER