Healthcare Provider Details

I. General information

NPI: 1376483495
Provider Name (Legal Business Name): LILYANN MARIE PEPPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4942 S 114TH ST
OMAHA NE
68137-2324
US

IV. Provider business mailing address

4942 S 114TH ST
OMAHA NE
68137-2324
US

V. Phone/Fax

Practice location:
  • Phone: 402-509-4480
  • Fax: 402-509-4480
Mailing address:
  • Phone: 402-509-4480
  • Fax: 402-509-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: