Healthcare Provider Details

I. General information

NPI: 1831988120
Provider Name (Legal Business Name): KASHEE DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6302 N 94TH PLZ APT 307
OMAHA NE
68122-1316
US

IV. Provider business mailing address

6302 N 94TH PLZ APT 307
OMAHA NE
68122-1316
US

V. Phone/Fax

Practice location:
  • Phone: 402-917-7981
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: