Kettelhut, Brett Van
Kettelhut, Brett Van is an sole proprietor health care provider with primary practice located at 2808 S 80 Ave Ste 210, Omaha NE 68124-3253. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical & Laboratory Immunology, Allopathic & Osteopathic Physicians / Allergy & Immunology. Allopathic & Osteopathic Physicians / Allergy & Immunology is his primary health care specialty. Kettelhut, Brett Van can be contacted via phone (402) 391-1800.Contact Information
Primary practice address
2808 S 80 Ave Ste 210
Omaha NE 68124-3253
Phone: (402) 391-1800
Fax: (402) 391-1563
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical & Laboratory Immunology | 207KI0005X | 21408 | Nebraska |
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 21408 | Nebraska |
Profile Details
| NPI number | 1538151204 |
|---|---|
| LBN Legal business name | Kettelhut, Brett Van |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 18th, 2005 |
| Last updated | Jun 30th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538151204 | NPPES |
| Nebraska | MEDICAID | 47060801504 | |
| Nebraska | MEDICAID | 47060801514 |
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