Individual
KERRI S OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7100 STEPHANIE LN STE 100, LINCOLN, NE 68516-5332
(402) 484-9009
(402) 483-4223
Mailing address
PO BOX 6068, LINCOLN, NE 68506-0068
(402) 484-9009
(402) 483-4223
Taxonomy
Speciality
Code
Description
License number
State
207NP0225X
Pediatric Dermatology Physician
1020
NE
207NS0135X
Procedural Dermatology Physician
1020
NE
363AM0700X
Medical Physician Assistant
Primary
1020
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47065843713
—
NE
Enumeration date
09/20/2006
Last updated
07/21/2022
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