1174610679 NPI number — SHERI JANELL KRAUS MA LIMHP CPC

Table of content: SHERI JANELL KRAUS MA LIMHP CPC (NPI 1174610679)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174610679 NPI number — SHERI JANELL KRAUS MA LIMHP CPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRAUS
Provider First Name:
SHERI
Provider Middle Name:
JANELL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA LIMHP CPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LYMAN
Provider Other First Name:
SHERI
Provider Other Middle Name:
JANELL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA LMHP CPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174610679
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/08/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11750 S 158TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BENNET
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-782-2010
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1617 NORMANDY CT
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68512-1474
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-525-3290
Provider Business Practice Location Address Fax Number:
402-420-1619
Provider Enumeration Date:
10/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  188 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 84362 . This is a "BCBS" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 10184 . This is a "MIDLANDS CHOICE" identifier . This identifiers is of the category "OTHER".




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