Healthcare Provider Details

I. General information

NPI: 1346054525
Provider Name (Legal Business Name): KARLA NAGENGAST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3809 ADAMS ST
LINCOLN NE
68504-1935
US

IV. Provider business mailing address

3809 ADAMS ST
LINCOLN NE
68504-1935
US

V. Phone/Fax

Practice location:
  • Phone: 402-466-4409
  • Fax: 402-475-6722
Mailing address:
  • Phone: 402-466-4409
  • Fax: 402-475-6722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number50865
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: