Provider Demographics
NPI:1457845786
Name:SKRDLA, KAMILLE MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:KAMILLE
Middle Name:MARIE
Last Name:SKRDLA
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 1:5251 S 52ND ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-1808
Mailing Address - Country:US
Mailing Address - Phone:402-657-2243
Mailing Address - Fax:
Practice Address - Street 1:1240 ARIES DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-9100
Practice Address - Country:US
Practice Address - Phone:402-420-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112491363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily