MEDICARE: TERESA RIVERA AVELAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant	F119730	NE

General Provider Information

NPI Number	:	1124828520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA RIVERA AVELAR

Provider Business Mailing Address
First Line	:	2324 S 10TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68108-1109
Country	:	US
Telephone Number	:	402-517-0385
Fax Number	:

Provider Business Practice Location Address
First Line	:	2324 S 10TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68108-1109
Country	:	US
Telephone Number	:	402-517-0385
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2025
Last Update Date	:	03/14/2025

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Directions to “ TERESA RIVERA AVELAR ” Practice Location

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