Individual
MARY KATHRYN ELLWANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-NP, CPNP-PC
Contact information
Practice address
11949 Q ST, OMAHA, NE 68137-3503
(531) 867-3088
Mailing address
14461 GRAND AVE, OMAHA, NE 68116-6623
(402) 881-6441
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
114233
NE
Other
Enumeration date
06/21/2022
Last updated
10/29/2025
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