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General NPI Number Information
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NPI Number | 1831978568
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Entity Type | Individual
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Provider Name | MARIELLA DI LEO APRN-NP
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Gender | Female
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Dates
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Enumeration Date | 09/22/2023
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 2255 S 132ND ST STE 100
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City | OMAHA
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State | NE
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Zip | 68144-2573
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Country | US
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Telephone | 402-614-4969
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Fax |
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Provider Business Mailing Address
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Address Line | 11807 S 29TH AVE
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City | BELLEVUE
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State | NE
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Zip | 68123-1453
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Country | US
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Telephone | 631-235-7111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 115030
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A186645
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | CP003660
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License Number State | SD
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