Healthcare Provider Details

I. General information

NPI: 1154233542
Provider Name (Legal Business Name): MRS. KELSEY JO JARESKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 ADAMY ST
COLUMBUS NE
68601-2973
US

IV. Provider business mailing address

4100 ADAMY ST
COLUMBUS NE
68601-2973
US

V. Phone/Fax

Practice location:
  • Phone: 402-563-7075
  • Fax: 402-563-7077
Mailing address:
  • Phone: 402-563-7075
  • Fax: 402-563-7077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number103380
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: