Healthcare Provider Details

I. General information

NPI: 1558294199
Provider Name (Legal Business Name): KELLY ANITA ALLSMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 KNOX ST
LINCOLN NE
68521-2748
US

IV. Provider business mailing address

350 KNOX ST
LINCOLN NE
68521-2748
US

V. Phone/Fax

Practice location:
  • Phone: 402-687-0269
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: