Active NPI
Karisa K Province
- Adult Companion
- Kearney, NE
National Provider Identifier
1316813421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- License
- H12364523
- Practice address
- 3808 4TH Ave
Kearney, NE 68845-2832 - Phone
- (308) 870-0469
- Fax
- (308) 870-0469
- NPI assigned
- Oct 15, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | H12364523 | NE | Primary |
Addresses
Primary practice location
3808 4TH Ave
Kearney, NE 68845-2832
Mailing address
3808 4TH Ave
Kearney, NE 68845-2832
Phone (308) 870-0469
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H12364523 | NE | MD | Adult Companion |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760486400000",
"number": "1316813421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3808 4TH AVE",
"city": "KEARNEY",
"state": "NE",
"postal_code": "688452832",
"telephone_number": "308-870-0469",
"fax_number": "308-870-0469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3808 4TH AVE",
"city": "KEARNEY",
"state": "NE",
"postal_code": "688452832",
"telephone_number": "308-870-0469",
"fax_number": "308-870-0469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROVINCE",
"first_name": "KARISA",
"middle_name": "K",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-10-15",
"last_updated": "2025-10-15",
"certification_date": "2025-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "NE",
"license": "H12364523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kearney, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.