Provider Demographics
NPI:1316733397
Name:KELLOGG, MINDY CHRISTINE
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:CHRISTINE
Last Name:KELLOGG
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 1:400 N 34TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-3222
Mailing Address - Country:US
Mailing Address - Phone:402-417-9410
Mailing Address - Fax:
Practice Address - Street 1:400 N 34TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68503-3222
Practice Address - Country:US
Practice Address - Phone:402-417-9410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty