Provider Demographics
NPI:1427510395
Name:ATKINS, KATIE (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:ATKINS
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8248 S 96TH ST
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-3126
Mailing Address - Country:US
Mailing Address - Phone:402-717-9510
Mailing Address - Fax:402-717-9511
Practice Address - Street 1:8248 S 96TH ST
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-3126
Practice Address - Country:US
Practice Address - Phone:402-717-9510
Practice Address - Fax:402-717-9511
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist