Provider Demographics
NPI:1063211035
Name:DIMAURO, SHAELYNNE
Entity type:Individual
Prefix:
First Name:SHAELYNNE
Middle Name:
Last Name:DIMAURO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11516 BURT ST APT E9
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-1550
Mailing Address - Country:US
Mailing Address - Phone:402-709-7042
Mailing Address - Fax:
Practice Address - Street 1:13906 GOLD CIR STE 103
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2336
Practice Address - Country:US
Practice Address - Phone:402-706-0772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant