Provider Demographics
NPI:1013359231
Name:CADORNA, CARRIE L (APRN)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:L
Last Name:CADORNA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:L
Other - Last Name:HERBRANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:111 S 90TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3907
Mailing Address - Country:US
Mailing Address - Phone:402-397-9800
Mailing Address - Fax:402-397-7591
Practice Address - Street 1:111 S 90TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3907
Practice Address - Country:US
Practice Address - Phone:402-397-9800
Practice Address - Fax:402-397-7591
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111547363L00000X
OK119576363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner