Provider Demographics
NPI:1912727231
Name:SUNDBERG, ELIZABETH GRACE (APRN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:GRACE
Last Name:SUNDBERG
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:PO BOX 3755
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-0755
Mailing Address - Country:US
Mailing Address - Phone:402-354-2100
Mailing Address - Fax:402-354-2155
Practice Address - Street 1:717 N 190TH PLZ STE 2200
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-3984
Practice Address - Country:US
Practice Address - Phone:402-815-2300
Practice Address - Fax:402-815-1045
Is Sole Proprietor?:No
Enumeration Date:2024-10-11
Last Update Date:2025-01-29
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Provider Licenses
StateLicense IDTaxonomies
NE115546363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner