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General NPI Number Information
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NPI Number | 1497165138
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Entity Type | Individual
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Provider Name | KEAIRA RENEE KHAUKHA OTR/L
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Gender | Female
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Dates
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Enumeration Date | 05/03/2014
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 5208 TIMBERRIDGE DR
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City | PAPILLION
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State | NE
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Zip | 68133-2759
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Country | US
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Telephone | 816-859-0839
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Fax |
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Provider Business Mailing Address
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Address Line | 6681 SORENSEN PKWY
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City | OMAHA
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State | NE
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Zip | 68152-2139
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Country | US
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Telephone | 402-932-8884
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Fax | 402-932-8885
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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 | 2767
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License Number State | NE
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