Provider Demographics
NPI:1962160127
Name:KAUFFMANN, JOYCE ANN (NEBRASKA PAS PROVIDE)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:KAUFFMANN
Suffix:
Gender:F
Credentials:NEBRASKA PAS PROVIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45
Mailing Address - Street 2:
Mailing Address - City:STEELE CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68440-0045
Mailing Address - Country:US
Mailing Address - Phone:402-442-2377
Mailing Address - Fax:
Practice Address - Street 1:216 S IDA ST
Practice Address - Street 2:
Practice Address - City:STEELE CITY
Practice Address - State:NE
Practice Address - Zip Code:68440-4023
Practice Address - Country:US
Practice Address - Phone:402-442-2377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE52698124253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE52698124Medicaid