Healthcare Provider Details

I. General information

NPI: 1003425828
Provider Name (Legal Business Name): KELSEY JAYE SVEHLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 FALLBROOK BLVD STE 200
LINCOLN NE
68521-9042
US

IV. Provider business mailing address

6825 S 27TH ST STE 103
LINCOLN NE
68512-4872
US

V. Phone/Fax

Practice location:
  • Phone: 402-420-0020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4083
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: