Healthcare Provider Details

I. General information

NPI: 1396672994
Provider Name (Legal Business Name): TAYAH PERKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 S 40TH ST
OMAHA NE
68105-1827
US

IV. Provider business mailing address

1920 FARNAM ST # 902
OMAHA NE
68102-1968
US

V. Phone/Fax

Practice location:
  • Phone: 531-239-2802
  • Fax:
Mailing address:
  • Phone: 531-239-2802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number170055
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: