Individual
KU PAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5015 N 60TH AVE, OMAHA, NE 68104-2003
(402) 208-2176
Mailing address
5015 N 60TH AVE, OMAHA, NE 68104-2003
(402) 208-2176
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
01/28/2025
Last updated
01/28/2025
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