Provider Demographics
NPI:1710587126
Name:KOHLSCHEEN, KEVIN K (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:K
Last Name:KOHLSCHEEN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7910 CASS ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3582
Mailing Address - Country:US
Mailing Address - Phone:402-384-8767
Mailing Address - Fax:
Practice Address - Street 1:7910 CASS ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3582
Practice Address - Country:US
Practice Address - Phone:402-384-8767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10175183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist