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General NPI Number Information
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NPI Number | 1629879622
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Entity Type | Individual
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Provider Name | BRENDA KAY LANDHOLM
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Gender | Female
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 3206 RAASCH DR STE 300
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City | NORFOLK
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State | NE
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Zip | 68701-3175
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Country | US
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Telephone | 402-860-4505
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Fax |
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Provider Business Mailing Address
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Address Line | 607 W CEDAR AVE APT 26
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City | NORFOLK
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State | NE
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Zip | 68701-2885
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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 | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 374P1801X
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number | 372600000X
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License Number State | NE
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Taxonomy #4
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number | 3747P1801X
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License Number State | NE
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Taxonomy #5
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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