Healthcare Provider Details

I. General information

NPI: 1134037526
Provider Name (Legal Business Name): SUSANA YASMIN CORTEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 N 104TH PLZ APT 315
OMAHA NE
68114-1146
US

IV. Provider business mailing address

12200 BURKE BLVD
OMAHA NE
68154-2327
US

V. Phone/Fax

Practice location:
  • Phone: 915-345-8725
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: