Healthcare Provider Details

I. General information

NPI: 1568370765
Provider Name (Legal Business Name): MRS. KAITLAN G KEMLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16929 FRANCES ST
OMAHA NE
68130-4683
US

IV. Provider business mailing address

13447 CEDAR ST
OMAHA NE
68144-2512
US

V. Phone/Fax

Practice location:
  • Phone: 531-355-7600
  • Fax:
Mailing address:
  • Phone: 402-619-0459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number79883
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: