MEDICARE: YOSELIN OLIVA HERNANDEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372500000X	Chore Provider

General Provider Information

NPI Number	:	1811786619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOSELIN OLIVA HERNANDEZ

Provider Business Mailing Address
First Line	:	10834 COTTONWOOD LN APT 8
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68164-3766
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10834 COTTONWOOD LN APT 8
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68164-3766
Country	:	US
Telephone Number	:	402-705-1246
Fax Number	:	402-705-1246

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2025
Last Update Date	:	05/06/2025

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