Healthcare Provider Details

I. General information

NPI: 1508727496
Provider Name (Legal Business Name): FARIDA E KHALAF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 N 48TH ST
LINCOLN NE
68504-3408
US

IV. Provider business mailing address

1865 W APRICOT LN
LINCOLN NE
68522-4421
US

V. Phone/Fax

Practice location:
  • Phone: 402-252-5154
  • Fax: 402-252-5047
Mailing address:
  • Phone: 402-252-5154
  • Fax: 402-252-5047

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: