Provider Demographics
NPI:1043790587
Name:NAHRIRI, SANDI S (DNP, APRN, FP-C)
Entity type:Individual
Prefix:DR
First Name:SANDI
Middle Name:S
Last Name:NAHRIRI
Suffix:
Gender:F
Credentials:DNP, APRN, FP-C
Other - Prefix:
Other - First Name:SANDI
Other - Middle Name:SUE
Other - Last Name:EVERS-NAHRIRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2602 J ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-1643
Mailing Address - Country:US
Mailing Address - Phone:402-733-3612
Mailing Address - Fax:402-734-7156
Practice Address - Street 1:2602 J ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-1643
Practice Address - Country:US
Practice Address - Phone:402-733-3612
Practice Address - Fax:402-734-7156
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1688522Medicaid