Provider Demographics
NPI:1528356888
Name:TAEGHAN, KAI A
Entity Type:Individual
Prefix:MS
First Name:KAI
Middle Name:A
Last Name:TAEGHAN
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 1:3901 NORMAL BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5250
Mailing Address - Country:US
Mailing Address - Phone:402-261-4017
Mailing Address - Fax:
Practice Address - Street 1:3901 NORMAL BLVD STE 201
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5250
Practice Address - Country:US
Practice Address - Phone:402-261-4017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator