Healthcare Provider Details

I. General information

NPI: 1255248977
Provider Name (Legal Business Name): KASEY KLOCEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

989200 NEBRASKA MEDICAL CTR
OMAHA NE
68198-9200
US

IV. Provider business mailing address

2710 N 109TH CT APT 212
OMAHA NE
68164-3704
US

V. Phone/Fax

Practice location:
  • Phone: 405-552-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19033
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: