Provider Demographics
NPI:1588324610
Name:KLAASMEYER, AMBER (APRN)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:KLAASMEYER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:WILLOUGHBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:12408 CRAWFORD RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-1426
Mailing Address - Country:US
Mailing Address - Phone:308-380-7045
Mailing Address - Fax:
Practice Address - Street 1:4350 DEWEY AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-1017
Practice Address - Country:US
Practice Address - Phone:402-559-8668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE113739363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE113739OtherNEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES