Healthcare Provider Details
I. General information
NPI: 1144029174
Provider Name (Legal Business Name): MRS. YANISBEL BUENO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1705 LAUREL LN
NORFOLK NE
68701-2642
US
IV. Provider business mailing address
1705 LAUREL LN
NORFOLK NE
68701-2642
US
V. Phone/Fax
- Phone: 402-860-6726
- Fax:
- Phone: 402-860-6726
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: