Healthcare Provider Details

I. General information

NPI: 1407933237
Provider Name (Legal Business Name): INDRA DOORPATIE SUKHRAM EJD, MSN, APRN-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S 70TH ST
LINCOLN NE
68510-2451
US

IV. Provider business mailing address

5200 W BLUEGILL CIR
DENTON NE
68339-9796
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-3802
  • Fax: 402-486-7861
Mailing address:
  • Phone: 402-489-3802
  • Fax: 402-486-7861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number110242
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number110242
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: