Healthcare Provider Details

I. General information

NPI: 1659283075
Provider Name (Legal Business Name): TAEJANAE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4916 BERNADETTE AVE
OMAHA NE
68157-2407
US

IV. Provider business mailing address

4916 BERNADETTE AVE
OMAHA NE
68157-2407
US

V. Phone/Fax

Practice location:
  • Phone: 402-659-4483
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: