Shada, Kelly Jo
Shada, Kelly Jo is an individual health care provider with primary practice located at 5205 2Nd Ave , Kearney NE 68847-2471. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Shada, Kelly Jo can be contacted via phone (308) 236-7545.Contact Information
Primary practice address
5205 2Nd Ave
Kearney NE 68847-2471
Phone: (308) 236-7545
Fax: (308) 236-7545
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 423 | Nebraska |
Profile Details
| NPI number | 1427190040 |
|---|---|
| LBN Legal business name | Shada, Kelly Jo |
| Credentials | R.N.,L.M.H.P. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 12th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1427190040 | NPPES |
| Nebraska | Other | 84306 | BLUE CROSS BLUE SHIELD |
| Nebraska | Other | 25690 | BLUE CROSS BLUE SHIELD |
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