Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tracey Lynn Ketchmark

Individual provider Contractor · NPI 1154129237

Tracey Lynn Ketchmark is a Contractor in Omaha, Nebraska. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

4715 S 132nd St
Omaha, NE 68137-1899
Phone: (308) 390-4378
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Contractor (primary) Taxonomy 171W00000X

Record details

NPI number1154129237
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 5, 2025
Last updated in NPPESApril 18, 2025
Certification dateApril 18, 2025
Mailing address4715 S 132nd St, Omaha, NE 68137-1899

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