Provider Demographics
NPI:1982490074
Name:TMMERMAN, KENNETH C (CPSS)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:C
Last Name:TMMERMAN
Suffix:
Gender:
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 NEWPORT AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68152-2153
Mailing Address - Country:US
Mailing Address - Phone:402-609-6350
Mailing Address - Fax:
Practice Address - Street 1:7101 NEWPORT AVE STE 207
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68152-2153
Practice Address - Country:US
Practice Address - Phone:402-609-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath