Healthcare Provider Details

I. General information

NPI: 1841136033
Provider Name (Legal Business Name): SHERAKA BASS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6916 N 102ND CIR
OMAHA NE
68122-3056
US

IV. Provider business mailing address

6916 N 102ND CIR
OMAHA NE
68122-3056
US

V. Phone/Fax

Practice location:
  • Phone: 402-739-8193
  • Fax:
Mailing address:
  • Phone: 402-739-8193
  • 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: