Individual
SHAMPAYNE FENTRESS-CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4932 CALIFORNIA ST, OMAHA, NE 68132-2418
(402) 830-1088
Mailing address
3030 MEREDITH AVE UNIT 111024, OMAHA, NE 68111-2446
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
25006459
NE
372600000X
Adult Companion
25006459
NE
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
04/08/2025
Last updated
04/08/2025
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