Provider Demographics
NPI:1962208629
Name:AGUIRRE-BERNAL, SAMANDA
Entity type:Individual
Prefix:MS
First Name:SAMANDA
Middle Name:
Last Name:AGUIRRE-BERNAL
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 1:4003 RAYNOR PKWY APT 1202
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-6114
Mailing Address - Country:US
Mailing Address - Phone:531-721-4105
Mailing Address - Fax:
Practice Address - Street 1:4003 RAYNOR PKWY APT 1202
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-6114
Practice Address - Country:US
Practice Address - Phone:531-721-4105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide