Healthcare Provider Details

I. General information

NPI: 1306628524
Provider Name (Legal Business Name): KIA TANAY SCOTT-SELLERS MSN, BSN, RN, FNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIA TANAY SCOTT

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/23/2023
Certification Date: 10/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 WOOLWORTH AVE
OMAHA NE
68105-1850
US

IV. Provider business mailing address

1308 BEAUFORT DR
PAPILLION NE
68133-2870
US

V. Phone/Fax

Practice location:
  • Phone: 402-346-8800
  • Fax:
Mailing address:
  • Phone: 402-651-7820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number91355
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: