MEDICARE: MCKAYLA JO DOBISH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide		NE
2	376K00000X	Nurse's Aide		NE

General Provider Information

NPI Number	:	1043028251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MCKAYLA JO DOBISH

Provider Business Mailing Address
First Line	:	708 CENTRAL AVE
Second Line	:
City	:	EDDYVILLE
State	:	NE
Zip	:	68834-2505
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	812 N TYLER ST
Second Line	:
City	:	LEXINGTON
State	:	NE
Zip	:	68850-2030
Country	:	US
Telephone Number	:	308-293-5781
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2024
Last Update Date	:	12/19/2024

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Directions to “ MCKAYLA JO DOBISH ” Practice Location

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