Provider Demographics
NPI:1790584373
Name:KINNEY, MAKAYLA E
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:E
Last Name:KINNEY
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 1:2521 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-3461
Mailing Address - Country:US
Mailing Address - Phone:531-270-4674
Mailing Address - Fax:
Practice Address - Street 1:5801 HIDCOTE DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5568
Practice Address - Country:US
Practice Address - Phone:402-665-4687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide