Fertig, Athena C
Fertig, Athena C is an individual health care provider with primary practice located at 300 W Broadway Ste 240 , Council Bluffs IA 51503-9028. She recently has 4 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Fertig, Athena C can be contacted via phone (712) 266-3577.Contact Information
Primary practice address
300 W Broadway Ste 240
Council Bluffs IA 51503-9028
Phone: (712) 266-3577
Fax: (712) 336-8541
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 111149 | Nebraska |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | A149479 | Iowa |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 111149 | Nebraska |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | G171495 | Iowa |
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | 111149 | Nebraska |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | A149479 | Iowa |
Profile Details
| NPI number | 1093028805 |
|---|---|
| LBN Legal business name | Fertig, Athena C |
| Credentials | APRN,PMHNP-BC,NP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2010 |
| Last updated | Sep 19th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093028805 | NPPES |
| Nebraska | Other | 48515 | BCBS NE (PLH) |
| Nebraska | Other | 47279 | BCBS NE (PLH) |
| Nebraska | MEDICAID | 10025024400 | BCBS NE (PLH) |
| Nebraska | MEDICAID | 10025024300 | BCBS NE (PLH) |
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