Provider Demographics
NPI:1316672421
Name:RIBAR, KATELYN KAY (APRN)
Entity type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:KAY
Last Name:RIBAR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:KATELYN
Other - Middle Name:KAY
Other - Last Name:REBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:4350 DEWEY AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105
Mailing Address - Country:US
Mailing Address - Phone:402-559-1077
Mailing Address - Fax:402-559-8873
Practice Address - Street 1:4350 DEWEY AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105
Practice Address - Country:US
Practice Address - Phone:402-559-1077
Practice Address - Fax:402-559-8873
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE114291363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care