Provider Demographics
NPI:1477347250
Name:PHIPPS, KELVIN
Entity type:Individual
Prefix:
First Name:KELVIN
Middle Name:
Last Name:PHIPPS
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 1:7802 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-5419
Mailing Address - Country:US
Mailing Address - Phone:402-689-7333
Mailing Address - Fax:
Practice Address - Street 1:1335 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-3504
Practice Address - Country:US
Practice Address - Phone:402-210-1733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider