Healthcare Provider Details

I. General information

NPI: 1336056902
Provider Name (Legal Business Name): LIZETTE TRIMINO
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: KYLE TRIMINO

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 AMES AVE
OMAHA NE
68104-2323
US

IV. Provider business mailing address

985450 NEBRASA MEDICAL CTR
OMAHA NE
68198-5450
US

V. Phone/Fax

Practice location:
  • Phone: 402-836-9781
  • Fax: 402-836-9565
Mailing address:
  • Phone: 402-559-9391
  • Fax: 402-559-5753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: