Organization
BELLEVUE PRIMARY HEALTHCARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLI RAE PAVLISH APRN (NURSE PRACTITIONER)
(402) 525-6976
Entity
Organization
Contact information
Practice address
12717 S 28TH AVE, BELLEVUE, NE 68123-3232
(402) 525-6976
Mailing address
703 CANYON RD, BELLEVUE, NE 68005-2735
(402) 525-6976
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
111265
NE
Other
Enumeration date
12/12/2012
Last updated
04/24/2024
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