Healthcare Provider Details

I. General information

NPI: 1174452817
Provider Name (Legal Business Name): IZABELLA THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11314 ELM ST
OMAHA NE
68144-4733
US

IV. Provider business mailing address

17207 CLAY ST
BENNINGTON NE
68007-3266
US

V. Phone/Fax

Practice location:
  • Phone: 402-981-8593
  • Fax:
Mailing address:
  • Phone: 402-981-8593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: