Provider Demographics
NPI:1598581829
Name:THOMAS, YVETTE LATASHA
Entity type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:LATASHA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YVETTE
Other - Middle Name:LATASHA
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3373 ERSKINE ST # NEUSA
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-3659
Mailing Address - Country:US
Mailing Address - Phone:402-598-0547
Mailing Address - Fax:
Practice Address - Street 1:3373 ERSKINE ST # NEUSA
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-3659
Practice Address - Country:US
Practice Address - Phone:402-598-0547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No372500000XNursing Service Related ProvidersChore Provider
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE28453107Medicaid