Individual
DR. KELLY DENENE GONZALES COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2211 CAPEHART RD, SUITE 104, BELLEVUE, NE 68123-2121
(402) 933-4111
(402) 934-4111
Mailing address
2211 CAPEHART RD, SUITE 104, BELLEVUE, NE 68123-2121
(402) 933-4111
(402) 934-4111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23335
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23335
STATE LICENSE
NE
Enumeration date
05/16/2006
Last updated
12/15/2009
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