Provider Demographics
NPI:1306628524
Name:SCOTT-SELLERS, KIA TANAY (MSN, BSN, RN, FNE)
Entity type:Individual
Prefix:
First Name:KIA
Middle Name:TANAY
Last Name:SCOTT-SELLERS
Suffix:
Gender:F
Credentials:MSN, BSN, RN, FNE
Other - Prefix:
Other - First Name:KIA
Other - Middle Name:TANAY
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1308 BEAUFORT DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68133-2870
Mailing Address - Country:US
Mailing Address - Phone:402-651-7820
Mailing Address - Fax:
Practice Address - Street 1:4101 WOOLWORTH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-1850
Practice Address - Country:US
Practice Address - Phone:402-346-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE91355163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care