Provider Demographics
NPI:1558593384
Name:TONNIGES, KRISTA K (OD)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:K
Last Name:TONNIGES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:K
Other - Last Name:LOSCHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40948 ROAD 768
Mailing Address - Street 2:
Mailing Address - City:GOTHENBURG
Mailing Address - State:NE
Mailing Address - Zip Code:69138-4054
Mailing Address - Country:US
Mailing Address - Phone:308-627-6171
Mailing Address - Fax:
Practice Address - Street 1:1401 S DEWEY ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-7622
Practice Address - Country:US
Practice Address - Phone:308-532-0220
Practice Address - Fax:308-532-0500
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1326152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist