Individual
KAYLI RENAE WHEATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6510 GLADSTONE ST, LINCOLN, NE 68507
(402) 870-1706
Mailing address
5905 O ST, LINCOLN, NE 68510-2235
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120732854
—
NE
Enumeration date
12/02/2022
Last updated
12/02/2022
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