Individual
BIANCA ANNABELLE TINAJERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2320 GATEWAY AVE, GRAND ISLAND, NE 68803-1437
(308) 380-6418
Mailing address
2320 GATEWAY AVE, GRAND ISLAND, NE 68803-1437
(308) 380-6418
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
H14266516
NE
Other
Enumeration date
12/04/2025
Last updated
12/04/2025
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