Provider Demographics
NPI:1063227445
Name:SPICER, KATHLEEN
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:SPICER
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 1:1731 COUNTY ROAD 13
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:NE
Mailing Address - Zip Code:68621-2120
Mailing Address - Country:US
Mailing Address - Phone:402-639-2791
Mailing Address - Fax:
Practice Address - Street 1:1731 COUNTY ROAD 13
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:NE
Practice Address - Zip Code:68621-2120
Practice Address - Country:US
Practice Address - Phone:402-639-2791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion