Provider Demographics
NPI:1982485611
Name:GUPTA, SHRITI
Entity Type:Individual
Prefix:MRS
First Name:SHRITI
Middle Name:
Last Name:GUPTA
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 1:1737 N 176TH PLZ # NE68118
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-6028
Mailing Address - Country:US
Mailing Address - Phone:531-225-8048
Mailing Address - Fax:
Practice Address - Street 1:1737 N 176TH PLZ # NE68118
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-6028
Practice Address - Country:US
Practice Address - Phone:531-225-8048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant