Healthcare Provider Details

I. General information

NPI: 1801772579
Provider Name (Legal Business Name): ALYSSA KOWALSKI
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 A ST
CENTRAL CITY NE
68826-1109
US

IV. Provider business mailing address

617 A ST
CENTRAL CITY NE
68826-1109
US

V. Phone/Fax

Practice location:
  • Phone: 308-830-9569
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number128423
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: