Provider Demographics
NPI:1952957102
Name:OPELA-SIERKS, CECELIA RAE (NP)
Entity Type:Individual
Prefix:
First Name:CECELIA
Middle Name:RAE
Last Name:OPELA-SIERKS
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 1:36 COUNTY ROAD 65
Mailing Address - Street 2:
Mailing Address - City:STAPLETON
Mailing Address - State:NE
Mailing Address - Zip Code:69163-5309
Mailing Address - Country:US
Mailing Address - Phone:308-636-8324
Mailing Address - Fax:
Practice Address - Street 1:601 W LEOTA ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6525
Practice Address - Country:US
Practice Address - Phone:308-568-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112798363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care