Individual
STACEY KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7905 L ST STE 420, OMAHA, NE 68127-1732
(402) 515-2654
Mailing address
4231 S 12TH ST, OMAHA, NE 68107-2310
(402) 801-6044
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
NE
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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