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Individual

DENISE MYRA CASILLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4545 S 86TH ST, LINCOLN, NE 68526-9227
(402) 483-6990
(402) 483-7045
Mailing address
4545 S 86TH ST, LINCOLN, NE 68526-9227
(402) 483-6990
(402) 483-7045

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
8188
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
470798717-26
NE
05
470798717-27
NE
05
470798717-29
NE
01
84757
BLUE CROSS AND BLUE SHIELD
NE
Enumeration date
04/30/2008
Last updated
04/30/2008
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