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General NPI Number Information
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NPI Number | 1407797327
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Entity Type | Individual
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Provider Name | CHARLES GREGORY WESTBROOK
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Gender | Male
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 1303 S 72ND ST STE 209
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City | OMAHA
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State | NE
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Zip | 68124-1604
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Country | US
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Telephone | 501-515-8882
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Fax |
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Provider Business Mailing Address
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Address Line | 14016 MANDERSON PLZ APT 101
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City | OMAHA
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State | NE
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Zip | 68164-6250
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number | H13328165
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License Number State | NE
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