Healthcare Provider Details
I. General information
NPI: 1821989310
Provider Name (Legal Business Name): MIDWEST MIND AND BODY HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2025
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
131 N WASHINGTON ST STE A
PAPILLION NE
68046-2434
US
IV. Provider business mailing address
7427 CASTLE ST
PAPILLION NE
68046-4716
US
V. Phone/Fax
- Phone: 531-217-5257
- Fax:
- Phone: 531-217-5257
- Fax: 949-864-3749
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KIMBERLY
A
WOHLWEND
Title or Position: OWNER, NURSE PRACTITIONER
Credential: FNP-BC, PMHNP-BC
Phone: 531-217-5257