Provider Demographics
NPI:1881193266
Name:KANGAS-PACKETT, SUSAN (RN, MSN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:KANGAS-PACKETT
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SOUTH 70TH ST.
Mailing Address - Street 2:EAST HIGH SCHOOL, HEALTH OFFICE
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510
Mailing Address - Country:US
Mailing Address - Phone:402-436-1302
Mailing Address - Fax:402-436-1329
Practice Address - Street 1:1000 SOUTH 70TH ST.
Practice Address - Street 2:EAST HIGH SCHOOL, HEALTH OFFICE
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510
Practice Address - Country:US
Practice Address - Phone:402-436-1302
Practice Address - Fax:402-436-1329
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE39510163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool