Healthcare Provider Details

I. General information

NPI: 1053273078
Provider Name (Legal Business Name): AZEEZAH JALAL ARAB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SANTE FE TRL
LINCOLN NE
68521-3254
US

IV. Provider business mailing address

711 N 48TH ST
LINCOLN NE
68504-3408
US

V. Phone/Fax

Practice location:
  • Phone: 402-252-5154
  • Fax:
Mailing address:
  • Phone: 402-252-5154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: