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NPI Code Detail

MEDICARE: JENITA R CROOMS

MEDICARE:   JENITA R CROOMS
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
13747P1801XPersonal Care AttendantNE

General Provider Information

NPI Number : 1295247104
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENITA R CROOMS
Provider Business Mailing Address
First Line : 1823 N 18TH ST
Second Line :
City : OMAHA
State : NE
Zip : 68110-2420
Country : US
Telephone Number : 402-917-5433
Fax Number :
Provider Business Practice Location Address
First Line : 14210 ARBOR ST STE A
Second Line :
City : OMAHA
State : NE
Zip : 68144-2382
Country : US
Telephone Number : 531-999-1133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2017
Last Update Date : 11/11/2025

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Directions to “ JENITA R CROOMS ” Practice Location

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