Provider Demographics
NPI:1063988509
Name:BROWN, KARLEY JACQUELINE
Entity type:Individual
Prefix:
First Name:KARLEY
Middle Name:JACQUELINE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KARLEY
Other - Middle Name:JACQUELINE
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:668 N PELHAM AVE
Mailing Address - Street 2:
Mailing Address - City:GILTNER
Mailing Address - State:NE
Mailing Address - Zip Code:68841-4533
Mailing Address - Country:US
Mailing Address - Phone:402-831-0787
Mailing Address - Fax:
Practice Address - Street 1:668 N PELHAM AVE
Practice Address - Street 2:
Practice Address - City:GILTNER
Practice Address - State:NE
Practice Address - Zip Code:68841-4533
Practice Address - Country:US
Practice Address - Phone:402-831-0787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE32154823Medicaid