Provider Demographics
NPI:1386449965
Name:GAZDA, ROSEMARY ANNE
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:ANNE
Last Name:GAZDA
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 1:1215 S 42ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1716
Mailing Address - Country:US
Mailing Address - Phone:402-595-2665
Mailing Address - Fax:
Practice Address - Street 1:12713 SLAYTON ST
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68138-4331
Practice Address - Country:US
Practice Address - Phone:402-740-0107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant