Provider Demographics
NPI:1033085881
Name:WESLEY, LATOYCE CHNELL
Entity type:Individual
Prefix:
First Name:LATOYCE
Middle Name:CHNELL
Last Name:WESLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4940 S 114TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2310
Mailing Address - Country:US
Mailing Address - Phone:402-671-1661
Mailing Address - Fax:402-982-4099
Practice Address - Street 1:4940 S 114TH ST STE 4
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2310
Practice Address - Country:US
Practice Address - Phone:402-671-1661
Practice Address - Fax:402-982-4099
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty