Provider Demographics
NPI:1073317541
Name:PERMENTER, RAELEE D
Entity type:Individual
Prefix:
First Name:RAELEE
Middle Name:D
Last Name:PERMENTER
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 1:121 N 19TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68003-1704
Mailing Address - Country:US
Mailing Address - Phone:402-940-3094
Mailing Address - Fax:
Practice Address - Street 1:121 N 19TH ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:NE
Practice Address - Zip Code:68003-1704
Practice Address - Country:US
Practice Address - Phone:402-940-3094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator