Individual provider Active NPI

Kristyn Nelsen

  • Pharmacist
  • Omaha, NE
National Provider Identifier
1093340283
Registry record updated Mar 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14983 Issued in NE
Practice address
1919 N 90TH St
Omaha, NE 68114-1316
Phone
(402) 391-2072
NPI assigned
Mar 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 14983 NE Primary

Addresses

Primary practice location

1919 N 90TH St
Omaha, NE 68114-1316

Mailing address

1919 N 90TH St
Omaha, NE 68114-1316
Phone (402) 391-2072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14983NEMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583625600000",
    "number": "1093340283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 N 90TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681141316",
            "telephone_number": "402-391-2072",
            "fax_number": "402-391-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 N 90TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681141316",
            "telephone_number": "402-391-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSEN",
        "first_name": "KRISTYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-08",
        "last_updated": "2020-03-08",
        "certification_date": "2020-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "14983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.