Individual
KALVIN ELEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2526 N 109TH TER APT 309, OMAHA, NE 68164-3827
(531) 444-0777
(531) 444-0777
Mailing address
2526 N 109TH TER APT 309, OMAHA, NE 68164-3827
(531) 444-0777
(531) 444-0777
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31989498
—
NE
Enumeration date
12/10/2018
Last updated
12/10/2018
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