Provider Demographics
NPI:1558167619
Name:HOMER, CORI A
Entity type:Individual
Prefix:
First Name:CORI
Middle Name:A
Last Name:HOMER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CORI
Other - Middle Name:
Other - Last Name:CHURCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2241 W TODD LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68528-1780
Mailing Address - Country:US
Mailing Address - Phone:402-429-7538
Mailing Address - Fax:
Practice Address - Street 1:2241 W TODD LN
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68528-1780
Practice Address - Country:US
Practice Address - Phone:402-429-7538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider