Healthcare Provider Details

I. General information

NPI: 1598339939
Provider Name (Legal Business Name): KRYSTLE M HAJEK APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 05/25/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 PINE LAKE RD
LINCOLN NE
68516-3389
US

IV. Provider business mailing address

5500 PINE LAKE RD
LINCOLN NE
68516-3389
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-8888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number113483
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: