Provider Demographics
NPI:1689631343
Name:ALDRIDGE, KRISTI L (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:L
Last Name:ALDRIDGE
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 1:6041 VILLAGE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5774
Mailing Address - Country:US
Mailing Address - Phone:402-423-1900
Mailing Address - Fax:
Practice Address - Street 1:6041 VILLAGE DR STE 150
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5774
Practice Address - Country:US
Practice Address - Phone:402-423-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110701363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47078557536Medicaid
NE279151Medicare ID - Type Unspecified
NE47078557536Medicaid