Provider Demographics
NPI:1356215677
Name:HENNESSY, KEELY REANN (CNA, CMA)
Entity type:Individual
Prefix:
First Name:KEELY
Middle Name:REANN
Last Name:HENNESSY
Suffix:
Gender:F
Credentials:CNA, CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEBRASKA CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68410-1370
Mailing Address - Country:US
Mailing Address - Phone:402-873-5513
Mailing Address - Fax:402-873-3463
Practice Address - Street 1:824 10TH AVE
Practice Address - Street 2:
Practice Address - City:NEBRASKA CITY
Practice Address - State:NE
Practice Address - Zip Code:68410-1370
Practice Address - Country:US
Practice Address - Phone:402-873-5513
Practice Address - Fax:402-873-3463
Is Sole Proprietor?:No
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE99921251J00000X
NE164802376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No251J00000XAgenciesNursing Care