Healthcare Provider Details

I. General information

NPI: 1861912453
Provider Name (Legal Business Name): KRISTEN M SPEAKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2017
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 O ST STE 112
LINCOLN NE
68510-2646
US

IV. Provider business mailing address

1445 W BURNHAM ST
LINCOLN NE
68522-9222
US

V. Phone/Fax

Practice location:
  • Phone: 402-765-4635
  • Fax: 402-207-6056
Mailing address:
  • Phone: 402-202-6922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number112250
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number112250
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: