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NPI Code Detail

MEDICARE: BROOKE KIMBALL

MEDICARE: BROOKE KIMBALL
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
1164W00000XLicensed Practical Nurse16448NE

General Provider Information

NPI Number : 1962366716
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE KIMBALL
Provider Business Mailing Address
First Line : 3101 N 58TH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68507-2210
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 420 VICTORY PARK DR
Second Line :
City : LINCOLN
State : NE
Zip : 68510-2484
Country : US
Telephone Number : 402-489-3802
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 12/15/2025

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Directions to “ BROOKE KIMBALL ” Practice Location

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