Healthcare Provider Details

I. General information

NPI: 1326956657
Provider Name (Legal Business Name): JACQUASHIA BILLUPS
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

3121 N 120TH CT APT 102
OMAHA NE
68164-4140
US

IV. Provider business mailing address

3121 N 120TH CT APT 102
OMAHA NE
68164-4140
US

V. Phone/Fax

Practice location:
  • Phone: 402-612-4271
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: