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General NPI Number Information
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NPI Number | 1194277145
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Entity Type | Individual
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Provider Name | JERILYN KLIEWER
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Gender | Female
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 245 S 22ND ST
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City | BLAIR
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State | NE
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Zip | 68008-1811
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Country | US
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Telephone | 402-426-2177
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Fax |
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Provider Business Mailing Address
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Address Line | 7608 FILLMORE ST
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City | OMAHA
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State | NE
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Zip | 68122-3901
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1925
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License Number State | NE
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