Provider Demographics
NPI:1841178365
Name:DE DIEGO-ALFARO, JILLIAN MARBETH
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:MARBETH
Last Name:DE DIEGO-ALFARO
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 1:4125 DUNN AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-5620
Mailing Address - Country:US
Mailing Address - Phone:402-620-1590
Mailing Address - Fax:
Practice Address - Street 1:4125 DUNN AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-5620
Practice Address - Country:US
Practice Address - Phone:402-620-1590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3747P1801X3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant