Individual
KELLY SUZANNE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, PCS
Contact information
Practice address
16910 FRANCES ST, STE. 102, OMAHA, NE 68130-2399
(402) 932-3355
(402) 932-3370
Mailing address
16910 FRANCES ST. STE. 102, CREIGHTON PEDIATRIC THERAPY, OMAHA, NE 68130
(402) 932-3355
(402) 932-3370
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2101
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47693
BLUE CROSS BLUE SHIELD
NE
Enumeration date
07/10/2008
Last updated
03/14/2012
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