Individual
BEIONKA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2511 N 61ST ST, OMAHA, NE 68104-4017
(531) 210-8090
Mailing address
2511 N 61ST ST, OMAHA, NE 68104-4017
(531) 210-8090
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
01/30/2025
Last updated
01/30/2025
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