Healthcare Provider Details

I. General information

NPI: 1538071725
Provider Name (Legal Business Name): MS. ANTONIA MARIE MARR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13805 Y CIR
OMAHA NE
68137-2830
US

IV. Provider business mailing address

13805 Y CIR
OMAHA NE
68137-2830
US

V. Phone/Fax

Practice location:
  • Phone: 402-619-7553
  • Fax:
Mailing address:
  • Phone: 402-619-7553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: