Healthcare Provider Details

I. General information

NPI: 1003759408
Provider Name (Legal Business Name): KELLY LEGGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 NW 1ST ST STE 7
LINCOLN NE
68521-4498
US

IV. Provider business mailing address

2481 E 5TH AVE APT 8
COLUMBUS NE
68601-7290
US

V. Phone/Fax

Practice location:
  • Phone: 402-440-5878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: