Provider Demographics
NPI:1053119966
Name:PLATT, RUBY RAKAYLA
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:RAKAYLA
Last Name:PLATT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 N 72ND ST APT 432
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3688
Mailing Address - Country:US
Mailing Address - Phone:402-609-6176
Mailing Address - Fax:
Practice Address - Street 1:2915 S 99TH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2604
Practice Address - Country:US
Practice Address - Phone:402-699-4602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE98949917Medicaid