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Individual

KELSEY LYNN BAXA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1520 S 70TH ST STE 200, LINCOLN, NE 68506
(402) 464-9000
(402) 464-4447
Mailing address
611 FENWICK DR, PAPILLION, NE 68046-5706
(402) 593-3141
(402) 593-3145

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
112192
NE
363LF0000X
Family Nurse Practitioner
112192
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
112192
NE MEDICAL LICENSE
NE
Enumeration date
03/17/2017
Last updated
05/22/2018
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