Healthcare Provider Details

I. General information

NPI: 1104227131
Provider Name (Legal Business Name): MRS. ELIZABETH ANN ZUNIGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 O ST # 1013
LINCOLN NE
68510-1957
US

IV. Provider business mailing address

4940 O ST # 1013
LINCOLN NE
68510-1957
US

V. Phone/Fax

Practice location:
  • Phone: 402-413-6263
  • Fax: 531-310-5965
Mailing address:
  • Phone: 402-413-6263
  • Fax: 531-310-5965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number15609685
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: