Healthcare Provider Details

I. General information

NPI: 1396683884
Provider Name (Legal Business Name): MS. MARY L. MEJIA-RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 S 15TH ST
OMAHA NE
68108-3555
US

IV. Provider business mailing address

1441 S 15TH ST
OMAHA NE
68108-3555
US

V. Phone/Fax

Practice location:
  • Phone: 402-201-7309
  • Fax:
Mailing address:
  • Phone: 402-201-7309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: