1982767976 NPI number — MRS. KATHRYN LOHRY ROSENBERGER MD

Table of content: MRS. KATHRYN LOHRY ROSENBERGER MD (NPI 1982767976)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982767976 NPI number — MRS. KATHRYN LOHRY ROSENBERGER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSENBERGER
Provider First Name:
KATHRYN
Provider Middle Name:
LOHRY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SWISHER
Provider Other First Name:
KATHRYN
Provider Other Middle Name:
LOHRY
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1982767976
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/27/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 S 48TH ST
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68506-1276
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-488-5600
Provider Business Mailing Address Fax Number:
402-488-7649

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 S 48TH ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68506-1276
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-488-5600
Provider Business Practice Location Address Fax Number:
402-488-7649
Provider Enumeration Date:
12/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  26073 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 47074354213 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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