Provider Demographics
NPI:1053119081
Name:PENA-BALBUENA, IRIS PAOLA
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:PAOLA
Last Name:PENA-BALBUENA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12623 SPAULDING PLZ LOT 314
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-1940
Mailing Address - Country:US
Mailing Address - Phone:402-547-0096
Mailing Address - Fax:
Practice Address - Street 1:12623 SPAULDING PLZ LOT 314
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-1940
Practice Address - Country:US
Practice Address - Phone:402-547-0096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide