Healthcare Provider Details

I. General information

NPI: 1215898739
Provider Name (Legal Business Name): ANNA-TALULA KOHLS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15677 SPAULDING ST
OMAHA NE
68116-8411
US

IV. Provider business mailing address

1611 S 133RD AVE
OMAHA NE
68144-1232
US

V. Phone/Fax

Practice location:
  • Phone: 402-614-8202
  • Fax:
Mailing address:
  • Phone: 402-614-8202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: