Provider Demographics
NPI:1881497139
Name:MANDAO, ANAYELEM II
Entity type:Individual
Prefix:MRS
First Name:ANAYELEM
Middle Name:
Last Name:MANDAO
Suffix:II
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6707 N 155TH TERRACE PLZ APT 4209
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-4614
Mailing Address - Country:US
Mailing Address - Phone:402-591-0732
Mailing Address - Fax:531-201-4505
Practice Address - Street 1:6707 N 155TH TERRACE PLZ APT 4209
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-4614
Practice Address - Country:US
Practice Address - Phone:402-591-0732
Practice Address - Fax:531-201-4505
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health