Provider Demographics
NPI:1144972373
Name:POLLETT, MCKINLEY (MS, ATC)
Entity type:Individual
Prefix:
First Name:MCKINLEY
Middle Name:
Last Name:POLLETT
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 LAPLATTE RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-4925
Mailing Address - Country:US
Mailing Address - Phone:402-517-1214
Mailing Address - Fax:
Practice Address - Street 1:2505 LAPLATTE RD
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-4925
Practice Address - Country:US
Practice Address - Phone:402-517-1214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
NE20000544672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer