Provider Demographics
NPI:1316318421
Name:OTTIS, BOBBI (APRN)
Entity type:Individual
Prefix:MRS
First Name:BOBBI
Middle Name:
Last Name:OTTIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:BOBBI
Other - Middle Name:
Other - Last Name:SCHULZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 W NORFOLK AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5221
Mailing Address - Country:US
Mailing Address - Phone:402-379-2030
Mailing Address - Fax:402-379-3933
Practice Address - Street 1:333 W NORFOLK AVE STE 201
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5221
Practice Address - Country:US
Practice Address - Phone:402-379-2030
Practice Address - Fax:402-379-3933
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE114875363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health