Provider Demographics
NPI:1053135509
Name:CEJA-DIAZ, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CEJA-DIAZ
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 1:300 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-2442
Mailing Address - Country:US
Mailing Address - Phone:308-324-4681
Mailing Address - Fax:
Practice Address - Street 1:300 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850-2442
Practice Address - Country:US
Practice Address - Phone:308-324-4681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant