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NPI 1003425828

NPI 1003425828 : KELSEY JAYE SVEHLA : LINCOLN, NE

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General NPI Number Information
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    NPI Number           |    1003425828
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    Entity Type          |    Individual 
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    Provider Name        |    KELSEY JAYE SVEHLA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/28/2020
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    Last Update Date     |    07/28/2020
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Provider Practice Location Address
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    Address Line         |    755 FALLBROOK BLVD STE 200 
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    City                 |    LINCOLN
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    State                |    NE
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    Zip                  |    68521-9042
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    Country              |    US
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    Telephone            |    402-420-0020
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6825 S 27TH ST STE 103 
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    City                 |    LINCOLN
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    State                |    NE
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    Zip                  |    68512-4872
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261Q00000X
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    Taxonomy Name        |    Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    4083
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    License Number State |    NE
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