Provider Demographics
NPI:1649085788
Name:D-WHITMAN, KALLIE MARIE
Entity type:Individual
Prefix:
First Name:KALLIE
Middle Name:MARIE
Last Name:D-WHITMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3526 N 176TH PLZ APT 208
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-2815
Mailing Address - Country:US
Mailing Address - Phone:402-670-5247
Mailing Address - Fax:
Practice Address - Street 1:2703 ALBERTA AVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68147-2468
Practice Address - Country:US
Practice Address - Phone:402-670-5247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider