Healthcare Provider Details

I. General information

NPI: 1699609636
Provider Name (Legal Business Name): KINLEY HADDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 CONRAD ST
RUSHVILLE NE
69360-6503
US

IV. Provider business mailing address

PO BOX 779
RUSHVILLE NE
69360-0779
US

V. Phone/Fax

Practice location:
  • Phone: 308-327-2026
  • Fax: 308-327-2126
Mailing address:
  • Phone: 308-372-2026
  • Fax: 308-327-2126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number390200000X
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: