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NPI 1972317378

NPI 1972317378 : PRICILLA WAKI : LINCOLN, NE

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General NPI Number Information
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    NPI Number           |    1972317378
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    Entity Type          |    Individual 
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    Provider Name        |    PRICILLA WAKI
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/05/2025
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    Last Update Date     |    02/05/2025
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Provider Practice Location Address
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    Address Line         |    3883 NORMAL BLVD STE 206 
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    City                 |    LINCOLN
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    State                |    NE
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    Zip                  |    68506-5218
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    Country              |    US
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    Telephone            |    402-488-4421
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    Fax                  |    402-904-4124
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Provider Business Mailing Address
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    Address Line         |    621 SURFSIDE DR 
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    City                 |    LINCOLN
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    State                |    NE
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    Zip                  |    68528-1099
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    Country              |    US
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    Telephone            |    531-229-3371
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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       |    
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    License Number State |    
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Taxonomy #3
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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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