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General NPI Number Information
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NPI Number | 1124062161
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Entity Type | Individual
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Provider Name | KIMBERLY KAY ANDERSON APRN, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 11060 OAK ST STE 6
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City | OMAHA
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State | NE
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Zip | 68144-4244
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Country | US
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Telephone | 402-889-3633
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Fax | 531-375-5196
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Provider Business Mailing Address
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Address Line | 906 S 184TH ST
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City | ELKHORN
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State | NE
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Zip | 68022-5756
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Country | US
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Telephone | 402-889-3633
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Fax | 531-375-5196
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 110373
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License Number State | NE
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