Provider Demographics
NPI:1215750039
Name:STYSKAL, KELSEY (RN)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:STYSKAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 W BEARTOOTH DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-3759
Mailing Address - Country:US
Mailing Address - Phone:402-813-3085
Mailing Address - Fax:
Practice Address - Street 1:VETERAN AFFAIRS
Practice Address - Street 2:420 VICTORY PARK DRIVE
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510
Practice Address - Country:US
Practice Address - Phone:402-813-3085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE81172163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management