Provider Demographics
NPI:1063723955
Name:KRIENERT, KELSI B (APRN)
Entity type:Individual
Prefix:
First Name:KELSI
Middle Name:B
Last Name:KRIENERT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KELSI
Other - Middle Name:B
Other - Last Name:WARNEKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:110 N 16TH ST
Mailing Address - Street 2:SUITE 16
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-3670
Mailing Address - Country:US
Mailing Address - Phone:402-644-7314
Mailing Address - Fax:402-644-7315
Practice Address - Street 1:110 N 16TH ST
Practice Address - Street 2:SUITE 16
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3670
Practice Address - Country:US
Practice Address - Phone:402-644-7314
Practice Address - Fax:402-644-7315
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111148363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE24616OtherBCBS NE
NEP00902990Medicare PIN
NE099827005Medicare PIN
NENA1466006Medicare PIN