Provider Demographics
NPI:1093449241
Name:KAST, CHRIS LINDA
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:LINDA
Last Name:KAST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISSAN
Other - Middle Name:LINDA
Other - Last Name:KAST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 W. NORFOLK AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5221
Mailing Address - Country:US
Mailing Address - Phone:402-379-2030
Mailing Address - Fax:402-379-3933
Practice Address - Street 1:333 W. NORFOLK AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5221
Practice Address - Country:US
Practice Address - Phone:402-379-2030
Practice Address - Fax:402-379-3933
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NECPSS-170171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE39189435426Medicaid