Provider Demographics
NPI:1164133906
Name:PELAYO, ANA B (NFP/CNA)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:B
Last Name:PELAYO
Suffix:
Gender:F
Credentials:NFP/CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5905 O ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2235
Mailing Address - Country:US
Mailing Address - Phone:402-436-1657
Mailing Address - Fax:
Practice Address - Street 1:5501 ASHLAND RD
Practice Address - Street 2:
Practice Address - City:CERESCO
Practice Address - State:NE
Practice Address - Zip Code:68017-4242
Practice Address - Country:US
Practice Address - Phone:402-436-1168
Practice Address - Fax:402-458-3268
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider