MEDICARE: ANGELIC S EILAND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant		NE

General Provider Information

NPI Number	:	1003621376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELIC S EILAND

Provider Business Mailing Address
First Line	:	3110 WILLIT ST APT 3
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68112-1749
Country	:	US
Telephone Number	:	402-708-1188
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 N 73RD ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68114-1800
Country	:	US
Telephone Number	:	402-708-1188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2025
Last Update Date	:	02/12/2025

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Directions to “ ANGELIC S EILAND ” Practice Location

Language	Start Address	Practice Location

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