Individual
KARISA K PROVINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3808 4TH AVE, KEARNEY, NE 68845-2832
(308) 870-0469
(308) 870-0469
Mailing address
3808 4TH AVE, KEARNEY, NE 68845-2832
(308) 870-0469
(308) 870-0469
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
H12364523
NE
Other
Enumeration date
10/15/2025
Last updated
10/15/2025
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