Healthcare Provider Details

I. General information

NPI: 1639015068
Provider Name (Legal Business Name): JESSICA ARRIAZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4814 OAKS LN
OMAHA NE
68137-2032
US

IV. Provider business mailing address

1221 N 170TH ST STE 317
OMAHA NE
68118-2932
US

V. Phone/Fax

Practice location:
  • Phone: 402-896-9988
  • Fax:
Mailing address:
  • Phone: 712-301-1723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number183350
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: