Provider Demographics
NPI:1407131543
Name:STORM, CHRISTY S (APRN)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:S
Last Name:STORM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:S
Other - Last Name:BOULOS STORM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4920 S 30TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-1656
Mailing Address - Country:US
Mailing Address - Phone:402-734-4110
Mailing Address - Fax:402-734-3990
Practice Address - Street 1:4920 S 30TH ST STE 103
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-1656
Practice Address - Country:US
Practice Address - Phone:402-734-4110
Practice Address - Fax:402-734-3990
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111312363LF0000X, 363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily