Healthcare Provider Details

I. General information

NPI: 1356203582
Provider Name (Legal Business Name): KELLY BEBEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12607 S 218TH AVE
GRETNA NE
68028-5984
US

IV. Provider business mailing address

12607 S 218TH AVE
GRETNA NE
68028-5984
US

V. Phone/Fax

Practice location:
  • Phone: 402-616-0438
  • Fax:
Mailing address:
  • Phone: 402-850-6720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: