Healthcare Provider Details

I. General information

NPI: 1912856485
Provider Name (Legal Business Name): SHATARA DARON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 N 15TH ST
LINCOLN NE
68521-5604
US

IV. Provider business mailing address

1299 FARNAM ST
OMAHA NE
68102-1880
US

V. Phone/Fax

Practice location:
  • Phone: 402-804-9155
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: