Basic Information
| Provider Information | |||||||||
| NPI: | 1841587987 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ESAU | ||||||||
| FirstName: | CARA | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | APRN-NP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MOORE | ||||||||
| OtherFirstName: | CARA | ||||||||
| OtherMiddleName: | L | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | APRN-NP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1110 N 10TH ST | ||||||||
| Address2: | |||||||||
| City: | BEATRICE | ||||||||
| State: | NE | ||||||||
| PostalCode: | 683102039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4022283344 | ||||||||
| FaxNumber: | 4022237213 | ||||||||
| Practice Location | |||||||||
| Address1: | 1110 N 10TH ST | ||||||||
| Address2: | |||||||||
| City: | BEATRICE | ||||||||
| State: | NE | ||||||||
| PostalCode: | 683102039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4022283344 | ||||||||
| FaxNumber: | 4022237213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2011 | ||||||||
| LastUpdateDate: | 08/17/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 111286 | NE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 111286 | 01 | NE | STATE OF NEBRASKA APRN-NP LICENSE | OTHER |