Healthcare Provider Details

I. General information

NPI: 1194614370
Provider Name (Legal Business Name): ALICIA ANN KOCHHEISER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICIA ANN ALLBERY

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2203 W DIVISION ST
GRAND ISLAND NE
68803-5332
US

IV. Provider business mailing address

2203 W DIVISION ST
GRAND ISLAND NE
68803-5332
US

V. Phone/Fax

Practice location:
  • Phone: 308-850-0403
  • Fax:
Mailing address:
  • Phone: 308-850-0403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: