Provider Demographics
NPI:1245123223
Name:MEMBRENO, YESICA ALEJANDRA
Entity type:Individual
Prefix:
First Name:YESICA
Middle Name:ALEJANDRA
Last Name:MEMBRENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4926 N 59TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-2153
Mailing Address - Country:US
Mailing Address - Phone:402-917-4867
Mailing Address - Fax:
Practice Address - Street 1:4926 N 59TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-2153
Practice Address - Country:US
Practice Address - Phone:402-917-4867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide