Individual
DEVONA STATION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4163 N 60TH AVE, OMAHA, NE 68104-2712
(402) 401-9871
Mailing address
4163 N 60TH AVE, OMAHA, NE 68104-2712
(402) 401-9871
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
07/26/2025
Last updated
07/26/2025
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