Provider Demographics
NPI:1922985647
Name:SUCKSTORF, BAMBININA KAREN (LPN)
Entity type:Individual
Prefix:
First Name:BAMBININA
Middle Name:KAREN
Last Name:SUCKSTORF
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:BAMBININA
Other - Middle Name:
Other - Last Name:SCHMODE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:54132 852 RD
Mailing Address - Street 2:
Mailing Address - City:PIERCE
Mailing Address - State:NE
Mailing Address - Zip Code:68767-3598
Mailing Address - Country:US
Mailing Address - Phone:402-851-0012
Mailing Address - Fax:
Practice Address - Street 1:3206 RAASCH DR STE 300
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3175
Practice Address - Country:US
Practice Address - Phone:402-379-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19545164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty