Individual
SHANTA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2505 JEFFERSON ST, OMAHA, NE 68107-4261
(402) 452-9694
Mailing address
2505 JEFFERSON ST, OMAHA, NE 68107-4261
(402) 452-9694
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/09/2026
Last updated
01/09/2026
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