Healthcare Provider Details

I. General information

NPI: 1669397212
Provider Name (Legal Business Name): ALICE DARLENE THOMAS CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13314 I ST
OMAHA NE
68137-1111
US

IV. Provider business mailing address

2237 BENSON GARDENS BLVD APT 2W
OMAHA NE
68134-6738
US

V. Phone/Fax

Practice location:
  • Phone: 402-401-1046
  • Fax: 402-401-1046
Mailing address:
  • Phone: 402-208-1489
  • Fax: 402-401-1046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number100370
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: