Provider Demographics
NPI:1790559292
Name:CHRISTINE KARELL PC LLO
Entity Type:Organization
Organization Name:CHRISTINE KARELL PC LLO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KARELL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:308-225-6572
Mailing Address - Street 1:815 FLACK AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-2722
Mailing Address - Country:US
Mailing Address - Phone:308-225-6572
Mailing Address - Fax:308-217-4277
Practice Address - Street 1:815 FLACK AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-2722
Practice Address - Country:US
Practice Address - Phone:308-225-6572
Practice Address - Fax:308-217-4277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE59122527500Medicaid