Healthcare Provider Details

I. General information

NPI: 1003459892
Provider Name (Legal Business Name): KATHLEEN HORSLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2019
Last Update Date: 10/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4741 N 26TH ST STE D
LINCOLN NE
68521-4707
US

IV. Provider business mailing address

4741 N 26TH ST STE D
LINCOLN NE
68521-4707
US

V. Phone/Fax

Practice location:
  • Phone: 402-438-5694
  • Fax: 402-465-0071
Mailing address:
  • Phone: 402-438-5694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number48708
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: