Provider Demographics
NPI:1083501787
Name:GEMAEHLICH, KALYSA
Entity type:Individual
Prefix:
First Name:KALYSA
Middle Name:
Last Name:GEMAEHLICH
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 1:204 W WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4142
Mailing Address - Country:US
Mailing Address - Phone:308-765-5397
Mailing Address - Fax:
Practice Address - Street 1:204 W WALNUT AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4142
Practice Address - Country:US
Practice Address - Phone:308-765-5397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEH140661103747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant