Healthcare Provider Details

I. General information

NPI: 1164185906
Provider Name (Legal Business Name): KRISTA LIERMAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4333 S 86TH ST
LINCOLN NE
68526-9260
US

IV. Provider business mailing address

915 3RD ST
BEEMER NE
68716-4202
US

V. Phone/Fax

Practice location:
  • Phone: 402-841-6343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number113553
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: