Provider Demographics
NPI:1831498112
Name:KRAHMER, ANALISA DYAN
Entity Type:Individual
Prefix:
First Name:ANALISA
Middle Name:DYAN
Last Name:KRAHMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 N 72ND ST STE 2400
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-1709
Mailing Address - Country:US
Mailing Address - Phone:402-717-0070
Mailing Address - Fax:402-717-0073
Practice Address - Street 1:6901 N 72ND ST STE 2400
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-1709
Practice Address - Country:US
Practice Address - Phone:402-717-0070
Practice Address - Fax:402-717-0073
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111225363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470376604-25Medicaid
IA1831498112Medicaid
NE470376604-25Medicaid