Provider Demographics
NPI:1255325502
Name:EGGERS, KRISTI V (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:V
Last Name:EGGERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:V
Other - Last Name:MUSSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 486
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:NE
Mailing Address - Zip Code:68979-0486
Mailing Address - Country:US
Mailing Address - Phone:402-773-0115
Mailing Address - Fax:402-773-0119
Practice Address - Street 1:301 S WAY AVE
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:NE
Practice Address - Zip Code:68979
Practice Address - Country:US
Practice Address - Phone:402-773-0115
Practice Address - Fax:402-773-0119
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110724363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100262738Medicaid
NE37704OtherBLUE CROSS BLUE SHIELD NE
NE47037877914Medicaid
NE37704OtherBLUE CROSS BLUE SHIELD NE