Healthcare Provider Details

I. General information

NPI: 1881503084
Provider Name (Legal Business Name): KASI MARIE OXFORD COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 TALL GRASS CIR
BENNET NE
68317-2411
US

IV. Provider business mailing address

50 TALL GRASS CIR
BENNET NE
68317-2411
US

V. Phone/Fax

Practice location:
  • Phone: 402-858-1555
  • Fax: 402-922-9289
Mailing address:
  • Phone: 402-858-1555
  • Fax: 402-922-9289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number1199
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: