Healthcare Provider Details

I. General information

NPI: 1568302842
Provider Name (Legal Business Name): KIARA FELICIANO MERCADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1934 N 31ST ST
LINCOLN NE
68503-1301
US

IV. Provider business mailing address

2430 Q ST APT 5
LINCOLN NE
68503-3603
US

V. Phone/Fax

Practice location:
  • Phone: 402-202-1884
  • Fax:
Mailing address:
  • Phone: 402-817-9163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number167790
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: