Individual provider · Type 1 NPI

Mary Kathryn Ellwanger, APRN-NP, CPNP-PC

Pediatric Nurse Practitioner · Omaha, NE

NPI number 1205567203 Active

Practice location

11949 Q St
Omaha, NE 68137-3503

Mailing address

14461 Grand Ave
Omaha, NE 68116-6623

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X114233 (NE)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1205567203

Mary Kathryn Ellwanger, APRN-NP, CPNP-PC's National Provider Identifier is 1205567203, issued on Jun 21, 2022. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Omaha, NE. The record was last updated on Oct 29, 2025.