Healthcare Provider Details

I. General information

NPI: 1164133906
Provider Name (Legal Business Name): ANA B PELAYO NFP/CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 ASHLAND RD
CERESCO NE
68017-4242
US

IV. Provider business mailing address

5905 O ST
LINCOLN NE
68510-2235
US

V. Phone/Fax

Practice location:
  • Phone: 402-436-1168
  • Fax: 402-458-3268
Mailing address:
  • Phone: 402-436-1657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateNE

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: