MEDICARE: OLGA ESPINOZA

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	171WH0202X	Home Modifications Contractor
2	171W00000X	Contractor

General Provider Information

NPI Number	:	1548058647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLGA ESPINOZA

Provider Business Mailing Address
First Line	:	5501 S 33RD AVE APT 1
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68107-3305
Country	:	US
Telephone Number	:	402-214-9792
Fax Number	:

Provider Business Practice Location Address
First Line	:	5501 S 33RD AVE APT 1
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68107-3305
Country	:	US
Telephone Number	:	402-214-9792
Fax Number	:

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

Provider Enumeration Date	:	04/28/2025
Last Update Date	:	04/28/2025

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Directions to “ OLGA ESPINOZA ” Practice Location

Language	Start Address	Practice Location

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