Provider Demographics
NPI:1821331786
Name:KOLEGRAFF, KELI (MD, PHD)
Entity Type:Individual
Prefix:
First Name:KELI
Middle Name:
Last Name:KOLEGRAFF
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 S 16TH ST STE 430
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3785
Mailing Address - Country:US
Mailing Address - Phone:402-483-8389
Mailing Address - Fax:402-483-8388
Practice Address - Street 1:2222 S 16TH ST STE 430
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3785
Practice Address - Country:US
Practice Address - Phone:402-483-8383
Practice Address - Fax:402-483-8388
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD471031208200000X
390200000X
NE34969208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program