Healthcare Provider Details

I. General information

NPI: 1225957418
Provider Name (Legal Business Name): MISS CARLIE KAY DUSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4471 41ST AVE STE 1004
COLUMBUS NE
68601-9405
US

IV. Provider business mailing address

26648 175TH ST
COLUMBUS NE
68601-6565
US

V. Phone/Fax

Practice location:
  • Phone: 402-590-4227
  • Fax:
Mailing address:
  • Phone: 402-697-5121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberH14112096
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: