Provider Demographics
NPI:1003564766
Name:MOSER, KRISTI DAWN (PLMHP)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:DAWN
Last Name:MOSER
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:DAWN
Other - Last Name:LEMKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11907 W PANAMA RD
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:NE
Mailing Address - Zip Code:68333-3357
Mailing Address - Country:US
Mailing Address - Phone:402-580-1701
Mailing Address - Fax:
Practice Address - Street 1:4316 S 48TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-1287
Practice Address - Country:US
Practice Address - Phone:531-224-4347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-12
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12849101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health