Provider Demographics
NPI:1336204718
Name:ESSINK, JUDITH M (APRN)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:M
Last Name:ESSINK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:M
Other - Last Name:SUPENSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:555 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2136
Mailing Address - Country:US
Mailing Address - Phone:402-280-8100
Mailing Address - Fax:402-280-8103
Practice Address - Street 1:14080 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:BOYS TOWN
Practice Address - State:NE
Practice Address - Zip Code:68010-7513
Practice Address - Country:US
Practice Address - Phone:402-778-6900
Practice Address - Fax:402-778-6917
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110283363L00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEQ23704Medicare UPIN