Healthcare Provider Details

I. General information

NPI: 1801392345
Provider Name (Legal Business Name): KIMBERLEY DAWN HEMMER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 04/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 W 9TH ST
NORTH BEND NE
68649-3514
US

IV. Provider business mailing address

341 W 10TH ST
NORTH BEND NE
68649-3549
US

V. Phone/Fax

Practice location:
  • Phone: 402-270-6928
  • Fax:
Mailing address:
  • Phone: 402-270-6928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number72656
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: