Healthcare Provider Details

I. General information

NPI: 1891617627
Provider Name (Legal Business Name): LILLYANA BRENNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 DODGE ST
OMAHA NE
68182-1102
US

IV. Provider business mailing address

1534 N 120TH PLZ APT 18
OMAHA NE
68154-1361
US

V. Phone/Fax

Practice location:
  • Phone: 402-554-2670
  • Fax:
Mailing address:
  • Phone: 719-640-2096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: