Healthcare Provider Details

I. General information

NPI: 1871401620
Provider Name (Legal Business Name): AMAYA ANGELIC LATZEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4120 BELLVILLE DR
LINCOLN NE
68521-1524
US

IV. Provider business mailing address

4120 BELLVILLE DR
LINCOLN NE
68521-1524
US

V. Phone/Fax

Practice location:
  • Phone: 402-430-6056
  • Fax:
Mailing address:
  • Phone: 402-430-6056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: