Provider Demographics
NPI:1053349142
Name:POPELKA, KATHLEEN ANN (DNSC, APRN)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ANN
Last Name:POPELKA
Suffix:
Gender:F
Credentials:DNSC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VAMC (11AC)
Mailing Address - Street 2:4101 WOOLWORTH AVE
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105
Mailing Address - Country:US
Mailing Address - Phone:402-346-8800
Mailing Address - Fax:402-995-5575
Practice Address - Street 1:VAMC (11AC)
Practice Address - Street 2:4101 WOOLWORTH AVE
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-1850
Practice Address - Country:US
Practice Address - Phone:402-346-8800
Practice Address - Fax:402-995-5575
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110130363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care