Provider Demographics
NPI:1104150150
Name:KREBER, SANDRA K (LAC)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:K
Last Name:KREBER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2418 CORNHUSKER RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-2412
Mailing Address - Country:US
Mailing Address - Phone:402-291-2121
Mailing Address - Fax:402-291-8957
Practice Address - Street 1:2418 CORNHUSKER RD
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-2412
Practice Address - Country:US
Practice Address - Phone:402-291-2121
Practice Address - Fax:402-291-8957
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist