Healthcare Provider Details

I. General information

NPI: 1790640266
Provider Name (Legal Business Name): MARIA CLAUDIA PARET MEDIAVILLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2208 N WEBB RD UNIT 4
GRAND ISLAND NE
68803-1756
US

IV. Provider business mailing address

2613 BRAHMA ST
GRAND ISLAND NE
68801-7615
US

V. Phone/Fax

Practice location:
  • Phone: 308-381-1690
  • Fax:
Mailing address:
  • Phone: 308-227-1862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: