Individual
KIMBERLY L NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8005 FARNAM DR STE 305, OMAHA, NE 68114-3426
(402) 390-4111
(402) 390-4115
Mailing address
8005 FARNAM DR STE 305, OMAHA, NE 68114-3426
(402) 390-4111
(402) 390-4115
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38661
BCBS
NE
01
—
P00408000
RR MEDICARE
—
Enumeration date
06/24/2006
Last updated
12/13/2023
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