Organization
KENNARD VOLUNTEER FIRE RESCUE SQUAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLEE MAREE NIELSEN (EMT)
(402) 533-3596
Entity
Organization
Contact information
Practice address
208 MAIN, KENNARD, NE 68034
(877) 218-4392
(877) 343-0131
Mailing address
10802 FARNAM DR, OMAHA, NE 68154-3237
(531) 895-5853
(877) 343-0131
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1167
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025044000
—
NE
01
—
39423
BLUE CROSS PROVIDER NO
NE
01
—
590012703
RR MEDICARE PROVIDER NO
—
Enumeration date
02/13/2007
Last updated
06/06/2023
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