Healthcare Provider Details

I. General information

NPI: 1700682507
Provider Name (Legal Business Name): EDWIGE KERE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 LORRAINE DR
BELLEVUE NE
68005-4966
US

IV. Provider business mailing address

6818 GROVER ST STE 200
OMAHA NE
68106-3632
US

V. Phone/Fax

Practice location:
  • Phone: 402-651-4880
  • Fax:
Mailing address:
  • Phone: 402-932-0072
  • Fax: 402-614-8245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: