Basic Information
Provider Information
NPI: 1831540418
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KNUTH
FirstName: WHITNEY
MiddleName:  
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Credential:  
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Mailing Information
Address1: 988102 NEBRASKA MEDICAL CTR
Address2:  
City: OMAHA
State: NE
PostalCode: 681988102
CountryCode: US
TelephoneNumber: 4025596195
FaxNumber:  
Practice Location
Address1: EMILE 42ND ST
Address2:  
City: OMAHA
State: NE
PostalCode: 681980001
CountryCode: US
TelephoneNumber: 4025594015
FaxNumber: 4025595581
Other Information
ProviderEnumerationDate: 06/25/2016
LastUpdateDate: 06/25/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X111987NEY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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