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General NPI Number Information
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NPI Number | 1275528200
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Entity Type | Individual
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Provider Name | KELLI CHRISTINE OSSENKOP PAC
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Gender | Female
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 2900 S 70TH ST STE 310
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City | LINCOLN
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State | NE
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Zip | 68506-3688
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Country | US
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Telephone | 402-434-5235
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Fax | 402-484-8891
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Provider Business Mailing Address
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Address Line | 6825 S 27TH ST STE 201
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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 | 402-434-5235
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Fax | 402-489-2137
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | NE809
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License Number State | NE
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