Provider Demographics
NPI:1376594572
Name:ARMITAGE, KAREN SUE (OD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:ARMITAGE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11811 FORT ST
Mailing Address - Street 2:STE 105
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-2134
Mailing Address - Country:US
Mailing Address - Phone:402-932-4800
Mailing Address - Fax:402-933-4530
Practice Address - Street 1:11811 FORT ST
Practice Address - Street 2:STE 105
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-2134
Practice Address - Country:US
Practice Address - Phone:402-932-4800
Practice Address - Fax:402-933-4530
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1045152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE36314OtherBCBS
NE100249756-00Medicaid
NE10917OtherMIDLAND'S CHOICE
NE100249756-00Medicaid
NEU49451Medicare UPIN