Healthcare Provider Details

I. General information

NPI: 1518451152
Provider Name (Legal Business Name): NAOMI KIGONDU PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 S 11TH ST
LINCOLN NE
68502-3559
US

IV. Provider business mailing address

2202 S 11TH ST
LINCOLN NE
68502-3559
US

V. Phone/Fax

Practice location:
  • Phone: 402-475-5161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60879307
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95027425
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA124634
License Number StateIA
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number112492
License Number StateNE
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG172492
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: