Provider Demographics
NPI:1275731531
Name:DARST, CHRISTOPHER J (PA)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:DARST
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S 48TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1275
Mailing Address - Country:US
Mailing Address - Phone:402-483-3333
Mailing Address - Fax:400-248-3329
Practice Address - Street 1:1600 S 48TH ST
Practice Address - Street 2:SUITE 600
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1275
Practice Address - Country:US
Practice Address - Phone:402-483-3333
Practice Address - Fax:400-248-3329
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE1333363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1333OtherSTATE LICENSE
NE1078169OtherNATIONAL COMMISSION OF CE