Healthcare Provider Details

I. General information

NPI: 1487589875
Provider Name (Legal Business Name): LILLIE HERBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13304 W CENTER RD STE 125
OMAHA NE
68144-3402
US

IV. Provider business mailing address

13304 W CENTER RD STE 125
OMAHA NE
68144-3402
US

V. Phone/Fax

Practice location:
  • Phone: 402-252-5442
  • Fax:
Mailing address:
  • Phone: 402-252-5442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number82746258
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: