Healthcare Provider Details

I. General information

NPI: 1578436770
Provider Name (Legal Business Name): KALEY BRANDENBURG DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 LUCILE DR STE 3
LINCOLN NE
68506-6004
US

IV. Provider business mailing address

4220 LUCILE DR STE 3
LINCOLN NE
68506-6004
US

V. Phone/Fax

Practice location:
  • Phone: 402-327-9000
  • Fax: 402-327-9003
Mailing address:
  • Phone: 402-327-9000
  • Fax: 402-327-9003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4867
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: