Provider Demographics
NPI:1497524813
Name:CARSTENS, ZACADIA ANN GRAVIN
Entity Type:Individual
Prefix:
First Name:ZACADIA
Middle Name:ANN GRAVIN
Last Name:CARSTENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZACADIA
Other - Middle Name:ANN GRAVIN
Other - Last Name:KRUEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1203 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5875
Mailing Address - Country:US
Mailing Address - Phone:402-371-0220
Mailing Address - Fax:
Practice Address - Street 1:1203 S 8TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5875
Practice Address - Country:US
Practice Address - Phone:402-371-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist