Healthcare Provider Details

I. General information

NPI: 1437081783
Provider Name (Legal Business Name): KAMRYN JENE BUCHANAN M.A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11060 OAK ST STE 6
OMAHA NE
68144-4244
US

IV. Provider business mailing address

3704 S 170TH CT
OMAHA NE
68130-2246
US

V. Phone/Fax

Practice location:
  • Phone: 402-881-2643
  • Fax:
Mailing address:
  • Phone: 402-881-2643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14939
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: