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General NPI Number Information
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NPI Number | 1760368112
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Entity Type | Individual
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Provider Name | KENNEDY ANNE ECHTERNKAMP
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Gender | Female
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 12600 S 82ND PL
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City | ROCA
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State | NE
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Zip | 68430-9682
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Country | US
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Telephone | 531-500-9050
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Fax |
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Provider Business Mailing Address
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Address Line | 812 MAPLE CT
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City | HICKMAN
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State | NE
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Zip | 68372-1404
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Country | US
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Telephone | 402-499-6842
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | NE
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