Healthcare Provider Details

I. General information

NPI: 1629930466
Provider Name (Legal Business Name): ANNA MARIE IIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4519 S 25TH ST
OMAHA NE
68107-1757
US

IV. Provider business mailing address

4519 S 25TH ST
OMAHA NE
68107-1757
US

V. Phone/Fax

Practice location:
  • Phone: 531-299-2780
  • Fax:
Mailing address:
  • Phone: 531-299-2780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: