Doctor Name: | MS. DIANE LYNN KOCOVSKY |
NPI Number: | 1669537056 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 110623 |
Business Practice Address: | 14080 Hospital Rd Boys Town, NE - 680107513 |
Business Phone Number: | 4027786900 |
Business Fax Number: | 4027786917 |
Mailing Address: | 555 N 30th St, OMAHA |
State: | NE |
Postal Code: | 681312136 |
Phone Number: | 4024986509 |
Fax Number: | 4024986357 |
NPI Enumeration Date: | 12/26/2006 |
NPI Last Update Date: | 02/14/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 110623 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |