Provider Demographics
NPI:1225926348
Name:BENITEZ RIVERA, EPIFANIA
Entity type:Individual
Prefix:
First Name:EPIFANIA
Middle Name:
Last Name:BENITEZ RIVERA
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 1:2646 Y ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-4417
Mailing Address - Country:US
Mailing Address - Phone:402-619-2164
Mailing Address - Fax:
Practice Address - Street 1:2646 Y ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-4417
Practice Address - Country:US
Practice Address - Phone:402-619-2164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant