Healthcare Provider Details

I. General information

NPI: 1922985647
Provider Name (Legal Business Name): BAMBININA KAREN SUCKSTORF LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BAMBININA SCHMODE LPN

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3206 RAASCH DR STE 300
NORFOLK NE
68701-3175
US

IV. Provider business mailing address

54132 852 RD
PIERCE NE
68767-3598
US

V. Phone/Fax

Practice location:
  • Phone: 402-379-3888
  • Fax:
Mailing address:
  • Phone: 402-851-0012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number19545
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: