Provider Demographics
NPI:1982046363
Name:KLUENDER, KONNI K (APRN)
Entity Type:Individual
Prefix:
First Name:KONNI
Middle Name:K
Last Name:KLUENDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KONNI
Other - Middle Name:K
Other - Last Name:SCHROEDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:113 WHISPERING PINES LN
Mailing Address - Street 2:
Mailing Address - City:VALENTINE
Mailing Address - State:NE
Mailing Address - Zip Code:69201-1600
Mailing Address - Country:US
Mailing Address - Phone:402-389-0040
Mailing Address - Fax:
Practice Address - Street 1:843 E 4TH ST STE A
Practice Address - Street 2:
Practice Address - City:AINSWORTH
Practice Address - State:NE
Practice Address - Zip Code:69210-1207
Practice Address - Country:US
Practice Address - Phone:402-389-0040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111552363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEPENDINGMedicaid
NEPENDINGMedicaid