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General NPI Number Information
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NPI Number | 1972218022
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Entity Type | Individual
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Provider Name | JAVIER ALEXANDER KENNEY
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Gender | Male
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 450 E 23RD ST
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City | FREMONT
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State | NE
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Zip | 68025-9802
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Country | US
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Telephone | 402-217-8666
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Fax |
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Provider Business Mailing Address
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Address Line | 2802 N 194TH CT APT 3B
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City | ELKHORN
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State | NE
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Zip | 68022-2616
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Country | US
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Telephone | 402-217-8666
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1233
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License Number State | NE
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