Provider Demographics
NPI:1457461824
Name:KOLDEN, BARBARA LOUISE (NP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LOUISE
Last Name:KOLDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 8TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PLATTSMOUTH
Mailing Address - State:NE
Mailing Address - Zip Code:68048-2365
Mailing Address - Country:US
Mailing Address - Phone:402-296-4451
Mailing Address - Fax:402-296-5154
Practice Address - Street 1:2302 8TH AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:PLATTSMOUTH
Practice Address - State:NE
Practice Address - Zip Code:68048-2365
Practice Address - Country:US
Practice Address - Phone:402-296-4451
Practice Address - Fax:402-296-5154
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110080363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47071211212Medicaid
271798Medicare ID - Type Unspecified
S82394Medicare UPIN