Healthcare Provider Details

I. General information

NPI: 1801713599
Provider Name (Legal Business Name): VINCENT GAMMONS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7810 WAKELEY PLZ STE 3
OMAHA NE
68114-3637
US

IV. Provider business mailing address

4619 CUMING ST
OMAHA NE
68132-2321
US

V. Phone/Fax

Practice location:
  • Phone: 402-281-6575
  • Fax:
Mailing address:
  • Phone: 402-281-6575
  • 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: