Healthcare Provider Details

I. General information

NPI: 1033067574
Provider Name (Legal Business Name): MRS. ALEXA KATHERINE RYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4330 W REBECCA LN
LINCOLN NE
68528-1122
US

IV. Provider business mailing address

18004 SUNRIDGE ST
OMAHA NE
68136-3220
US

V. Phone/Fax

Practice location:
  • Phone: 402-350-5141
  • Fax:
Mailing address:
  • Phone: 402-350-5141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: