Provider Demographics
NPI:1295521839
Name:DOEDEN, KAYLEEN MARIE
Entity type:Individual
Prefix:
First Name:KAYLEEN
Middle Name:MARIE
Last Name:DOEDEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:NE
Mailing Address - Zip Code:68450-2321
Mailing Address - Country:US
Mailing Address - Phone:402-335-8264
Mailing Address - Fax:
Practice Address - Street 1:171 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:NE
Practice Address - Zip Code:68450-2321
Practice Address - Country:US
Practice Address - Phone:402-335-8264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant