Healthcare Provider Details

I. General information

NPI: 1124827092
Provider Name (Legal Business Name): KEYADA GALES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8273 CRAIG AVE # OMAHANE
OMAHA NE
68122-1279
US

IV. Provider business mailing address

8273 CRAIG AVE # OMAHANE
OMAHA NE
68122-1279
US

V. Phone/Fax

Practice location:
  • Phone: 402-714-3841
  • Fax:
Mailing address:
  • Phone: 402-714-3841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number149765
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: