Individual
MS. KRISTY LYNN MIXAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
425 N 30TH ST, OMAHA, NE 68131-2100
(402) 452-5000
(402) 452-5028
Mailing address
555 N 30TH ST, OMAHA, NE 68131-2136
(402) 280-8100
(402) 280-8103
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1422
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84366
BCBS BT
NE
01
—
84445
BCBS ENT
NE
Enumeration date
02/06/2007
Last updated
11/22/2010
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