Healthcare Provider Details

I. General information

NPI: 1487579652
Provider Name (Legal Business Name): IAN RAYNE WOODS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 N PINE ST
CHADRON NE
69337-2038
US

IV. Provider business mailing address

11011 Q ST STE 101C
OMAHA NE
68137-3700
US

V. Phone/Fax

Practice location:
  • Phone: 980-280-9196
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: