Provider Demographics
NPI:1558249763
Name:ADAME VAZQUEZ, MARINA
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:ADAME VAZQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 CHERRYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:NE
Mailing Address - Zip Code:68333-1823
Mailing Address - Country:US
Mailing Address - Phone:402-381-7078
Mailing Address - Fax:
Practice Address - Street 1:4004 PIONEER WOODS DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-7548
Practice Address - Country:US
Practice Address - Phone:402-484-4900
Practice Address - Fax:402-817-0189
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE28010164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse