Healthcare Provider Details

I. General information

NPI: 1023638434
Provider Name (Legal Business Name): HOLLY BUELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2020
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 SAWYER ST
LINCOLN NE
68505-3702
US

IV. Provider business mailing address

1819 SAWYER ST
LINCOLN NE
68505-3702
US

V. Phone/Fax

Practice location:
  • Phone: 402-540-6521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number127332
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: