Provider Demographics
NPI:1295547388
Name:WANGAI, PETER
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:WANGAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 CORNHUSKER RD STE 105 PMB 351
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-4091
Mailing Address - Country:US
Mailing Address - Phone:402-915-0499
Mailing Address - Fax:
Practice Address - Street 1:505 CORNHUSKER RD STE 105 PMB 351
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-4091
Practice Address - Country:US
Practice Address - Phone:402-915-0499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE251E00000X
343900000X, 372600000X, 3747P1801X, 374U00000X, 372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide