Healthcare Provider Details

I. General information

NPI: 1255292074
Provider Name (Legal Business Name): THOMASINA ROSE JENKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: THOMASINA ROSE MILLER

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

2723 Q ST
OMAHA NE
68107-3408
US

IV. Provider business mailing address

2723 Q ST
OMAHA NE
68107-3408
US

V. Phone/Fax

Practice location:
  • Phone: 402-320-5188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number$$$$$$$$$
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: