Provider Demographics
NPI:1932098563
Name:FANTROY, PAULA W (CNA)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:W
Last Name:FANTROY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5021 ARCADIA AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-1333
Mailing Address - Country:US
Mailing Address - Phone:402-208-3186
Mailing Address - Fax:
Practice Address - Street 1:5021 ARCADIA AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-1333
Practice Address - Country:US
Practice Address - Phone:402-208-3186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide