Individual
ABBIE L KETCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
8248 S 96TH ST, LA VISTA, NE 68128-3126
(402) 717-9500
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
112996
NE
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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