Healthcare Provider Details

I. General information

NPI: 1114831906
Provider Name (Legal Business Name): KAYLA JOHANEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7166 N 163RD ST
BENNINGTON NE
68007-1934
US

IV. Provider business mailing address

126 N ALLEN ST
BENNINGTON NE
68007-5043
US

V. Phone/Fax

Practice location:
  • Phone: 402-443-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: