Healthcare Provider Details

I. General information

NPI: 1669384525
Provider Name (Legal Business Name): REGINA ROCHELLE ABRAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5004 N 27TH ST # 68111
OMAHA NE
68111-2041
US

IV. Provider business mailing address

5004 N 27TH ST # NE68111
OMAHA NE
68111-2041
US

V. Phone/Fax

Practice location:
  • Phone: 531-301-7573
  • Fax:
Mailing address:
  • Phone: 531-301-7573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: