Khcole Willis
Technician, Personal Care Attendant in Omaha, NE. Individual provider (NPI-1).
NPI number1053118331
StatusActive
Last updated in NPPESFeb 25, 2025
Details
- NPI
- 1053118331
- Entity type
- Individual (NPI-1)
- Name
- Khcole Willis
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 25, 2025
- Certification date
- Feb 25, 2025
- Last updated
- Feb 25, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
Practice location
4816 S 24th St # 14Omaha, NE 68107-2703
Phone 402-320-5578
Mailing address
3016 Lafayette AveOmaha, NE 68131-1465
Phone 402-708-0846
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