Provider Demographics
NPI:1316747025
Name:WATSON-HERNANDEZ, DAINI JO
Entity type:Individual
Prefix:
First Name:DAINI
Middle Name:JO
Last Name:WATSON-HERNANDEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:DAINI
Other - Middle Name:JO
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3519 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-3258
Mailing Address - Country:US
Mailing Address - Phone:531-800-2824
Mailing Address - Fax:
Practice Address - Street 1:3519 N 30TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-3258
Practice Address - Country:US
Practice Address - Phone:402-208-2940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant