Individual
ILMARIELIANY ACOSTA BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
645 S 20TH ST APT E24, LINCOLN, NE 68510-2730
(978) 764-5942
Mailing address
300 45TH ST S, FARGO, ND 58103-1189
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236
—
DC
01
—
568946544
BCBS
—
01
—
5874
HEALTH PARTNERS
—
Enumeration date
02/26/2025
Last updated
02/26/2025
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