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Individual

MRS. KIMBERLY WUTSNU-BEATRICE GILMORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
15652 N 4TH ST APT 11, BENNINGTON, NE 68007-5453
(402) 812-9156
Mailing address
9433 HIMEBAUGH CIR, OMAHA, NE 68134-1600
(402) 706-1357

Taxonomy

Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
86862439
NE
3747P1801X
Personal Care Attendant
45876737
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
45876737
NE
05
86826439
NE
Enumeration date
12/15/2021
Last updated
01/28/2025
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