Healthcare Provider Details

I. General information

NPI: 1740145267
Provider Name (Legal Business Name): PRENTEL Z CARTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16909 LAKESIDE HILLS PLZ STE 114
OMAHA NE
68130-4652
US

IV. Provider business mailing address

16909 LAKESIDE HILLS PLZ STE 114
OMAHA NE
68130-4652
US

V. Phone/Fax

Practice location:
  • Phone: 402-932-2211
  • Fax: 402-932-9002
Mailing address:
  • Phone: 402-932-2211
  • Fax: 402-932-9002

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: