Provider Demographics
NPI:1033340724
Name:CARDA, ANDREA JAE (OD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JAE
Last Name:CARDA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:JAE
Other - Last Name:WITTROCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2380 8TH AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:PLATTSMOUTH
Mailing Address - State:NE
Mailing Address - Zip Code:68048-2367
Mailing Address - Country:US
Mailing Address - Phone:402-296-2200
Mailing Address - Fax:402-296-6055
Practice Address - Street 1:2380 8TH AVE STE 4
Practice Address - Street 2:
Practice Address - City:PLATTSMOUTH
Practice Address - State:NE
Practice Address - Zip Code:68048-2367
Practice Address - Country:US
Practice Address - Phone:402-296-2200
Practice Address - Fax:402-296-6055
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2506152W00000X
NE1361152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist