Provider Demographics
NPI:1962815720
Name:LOUTZENHISER, BROOKE JEAN (APRN-NNP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:JEAN
Last Name:LOUTZENHISER
Suffix:
Gender:F
Credentials:APRN-NNP
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:JEAN
Other - Last Name:TEKOLSTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-NNP
Mailing Address - Street 1:8200 DODGE STREET
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114
Mailing Address - Country:US
Mailing Address - Phone:402-955-3400
Mailing Address - Fax:402-955-3393
Practice Address - Street 1:8200 DODGE STREET
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114
Practice Address - Country:US
Practice Address - Phone:402-955-6156
Practice Address - Fax:402-955-3393
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111714363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal