Healthcare Provider Details

I. General information

NPI: 1235042128
Provider Name (Legal Business Name): ADDISON JEAN LESLIE CARNAHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

837 CHESTNUT AVE
HASTINGS NE
68901-4257
US

IV. Provider business mailing address

837 CHESTNUT AVE
HASTINGS NE
68901-4257
US

V. Phone/Fax

Practice location:
  • Phone: 402-519-5197
  • Fax:
Mailing address:
  • Phone: 402-519-5197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: