Provider Demographics
NPI:1346258027
Name:DAMGAARD, KARLA ELIZABETH (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:ELIZABETH
Last Name:DAMGAARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 IVY ST
Mailing Address - Street 2:P.O. BOX 47
Mailing Address - City:STANTON
Mailing Address - State:NE
Mailing Address - Zip Code:68779-2348
Mailing Address - Country:US
Mailing Address - Phone:402-439-5500
Mailing Address - Fax:402-439-5502
Practice Address - Street 1:902 IVY ST
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:NE
Practice Address - Zip Code:68779-2348
Practice Address - Country:US
Practice Address - Phone:402-439-5500
Practice Address - Fax:402-439-5502
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110041363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE37848OtherBLUE CROSS BLUE SHIELD NE
NE10025134900Medicaid
NE10025134900Medicaid
NE278178Medicare PIN