Kelly Fanning
Individual provider Active NPI Personal Care Attendant · Creighton, NE
NPI 1699655779 · NPPES record last updated Sep 8, 2025
Key facts
- NPI
- 1699655779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 610 Redick Ave
Creighton, NE 68729-4008 - Phone
- (402) 929-0031
- NPI assigned
- Sep 8, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
610 Redick Ave
Creighton, NE 68729-4008
Mailing address
610 Redick Ave
Creighton, NE 68729-4008
Phone (402) 929-0031
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All providers in Creighton, NE · Personal Care Attendant in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.