Individual
JENTY IDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3336 MANDERSON ST, OMAHA, NE 68111-2834
(402) 812-0272
Mailing address
3336 MANDERSON ST, OMAHA, NE 68111-2834
(402) 812-0272
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
02/14/2025
Last updated
02/14/2025
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