Healthcare Provider Details

I. General information

NPI: 1770444705
Provider Name (Legal Business Name): ESTELLA MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11605 W DODGE RD STE 4
OMAHA NE
68154-2566
US

IV. Provider business mailing address

5632 CEDAR ST
OMAHA NE
68106-2236
US

V. Phone/Fax

Practice location:
  • Phone: 402-979-7770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: