Provider Demographics
NPI:1063210268
Name:BRIBIESECA, MINIIMAH H
Entity type:Individual
Prefix:
First Name:MINIIMAH
Middle Name:H
Last Name:BRIBIESECA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12020 SHAMROCK PLZ STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-3537
Mailing Address - Country:US
Mailing Address - Phone:402-698-0098
Mailing Address - Fax:
Practice Address - Street 1:1402 JONES ST STE 211
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-3218
Practice Address - Country:US
Practice Address - Phone:402-800-7759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEH14137594376J00000X, 374U00000X
372600000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide