Provider Demographics
NPI:1811707722
Name:COVER, KELSEE
Entity type:Individual
Prefix:
First Name:KELSEE
Middle Name:
Last Name:COVER
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 1:823 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CRAWFORD
Mailing Address - State:NE
Mailing Address - Zip Code:69339-1155
Mailing Address - Country:US
Mailing Address - Phone:308-207-5863
Mailing Address - Fax:
Practice Address - Street 1:908 5TH ST
Practice Address - Street 2:
Practice Address - City:CRAWFORD
Practice Address - State:NE
Practice Address - Zip Code:69339-1204
Practice Address - Country:US
Practice Address - Phone:308-665-1928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant