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Individual

KELLI L. PIRRUCCELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
707 N 190TH PLZ, ELKHORN, NE 68022-3974
(402) 815-6428
(402) 815-1565
Mailing address
PO BOX 2797, OMAHA, NE 68103-2797
(402) 354-4230
(402) 354-6171

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
71216
NE
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
111868
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100258661-00
NE
05
1073996021
IA
Enumeration date
07/08/2015
Last updated
09/02/2015
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