Healthcare Provider Details

I. General information

NPI: 1386569119
Provider Name (Legal Business Name): JASMIN IZAGUIRRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 W PEACH ST
LINCOLN NE
68522-1566
US

IV. Provider business mailing address

1807 W PEACH ST
LINCOLN NE
68522-1566
US

V. Phone/Fax

Practice location:
  • Phone: 402-480-4920
  • Fax:
Mailing address:
  • Phone: 402-480-4920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: