Healthcare Provider Details

I. General information

NPI: 1669376331
Provider Name (Legal Business Name): GEORGETTE HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4809 N 130TH CIR
OMAHA NE
68164-1764
US

IV. Provider business mailing address

4809 N 130TH CIR
OMAHA NE
68164-1764
US

V. Phone/Fax

Practice location:
  • Phone: 785-342-7602
  • Fax:
Mailing address:
  • Phone: 785-342-7602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number372600000X
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: