Provider Demographics
NPI:1700137221
Name:KATIE M. PARSONS, O.D. P.C.
Entity type:Organization
Organization Name:KATIE M. PARSONS, O.D. P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING AND INSURANCE CLAIMS
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-420-0880
Mailing Address - Street 1:1401 INFINITY RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-3712
Mailing Address - Country:US
Mailing Address - Phone:402-420-0880
Mailing Address - Fax:402-420-0668
Practice Address - Street 1:1401 INFINITY RD STE D
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-3713
Practice Address - Country:US
Practice Address - Phone:402-420-0880
Practice Address - Fax:402-420-0668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-24
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332H00000X
NE1301152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1982865838OtherNPI