Provider Demographics
NPI:1083325351
Name:ESTRADA, ESTHEFANY ALEJANDRA (APRN, DNP)
Entity Type:Individual
Prefix:
First Name:ESTHEFANY
Middle Name:ALEJANDRA
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:APRN, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 W AURORA ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68524-2122
Mailing Address - Country:US
Mailing Address - Phone:308-325-8504
Mailing Address - Fax:
Practice Address - Street 1:5701 W AURORA ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68524-2122
Practice Address - Country:US
Practice Address - Phone:308-325-8504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE114484363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care