Healthcare Provider Details

I. General information

NPI: 1902735731
Provider Name (Legal Business Name): K'DEN BRUNNER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7626 HAMILTON ST
OMAHA NE
68114-1728
US

IV. Provider business mailing address

7200 S 84TH ST
LA VISTA NE
68128-2115
US

V. Phone/Fax

Practice location:
  • Phone: 402-218-9252
  • Fax:
Mailing address:
  • Phone: 402-541-6589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: