Provider Demographics
NPI:1336803477
Name:KUEHN, ALYSSA NICHOLE
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:NICHOLE
Last Name:KUEHN
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 1:341 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:DODGE
Mailing Address - State:NE
Mailing Address - Zip Code:68633-3024
Mailing Address - Country:US
Mailing Address - Phone:402-920-1298
Mailing Address - Fax:
Practice Address - Street 1:13306 A ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3660
Practice Address - Country:US
Practice Address - Phone:402-339-7727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1944225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant