Provider Demographics
NPI:1982498549
Name:HERNANDEZ, LIZZETTE ESMERALDA
Entity type:Individual
Prefix:
First Name:LIZZETTE
Middle Name:ESMERALDA
Last Name:HERNANDEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:LIZZETTE
Other - Middle Name:ESMERALDA
Other - Last Name:MARROQUIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:210 SANTE FE TRL
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-3252
Mailing Address - Country:US
Mailing Address - Phone:402-217-0871
Mailing Address - Fax:
Practice Address - Street 1:210 SANTE FE TRL
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-3252
Practice Address - Country:US
Practice Address - Phone:402-217-0871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty