Healthcare Provider Details

I. General information

NPI: 1427875194
Provider Name (Legal Business Name): AMANDA SRYGLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13322 I ST
OMAHA NE
68137-1111
US

IV. Provider business mailing address

13322 I ST
OMAHA NE
68137-1111
US

V. Phone/Fax

Practice location:
  • Phone: 402-230-5861
  • Fax: 531-200-5808
Mailing address:
  • Phone: 402-230-5861
  • Fax: 531-200-5808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-380133
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: