Healthcare Provider Details

I. General information

NPI: 1376432369
Provider Name (Legal Business Name): HILDA MARIA SICILIA CANIZARES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19535 BLONDO PKWY
ELKHORN NE
68022-3012
US

IV. Provider business mailing address

19535 BLONDO PKWY
ELKHORN NE
68022-3012
US

V. Phone/Fax

Practice location:
  • Phone: 308-390-2163
  • Fax:
Mailing address:
  • Phone: 308-390-2163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: