Provider Demographics
NPI:1104702869
Name:ESTEVEZ ARCIA, DAILIS
Entity type:Individual
Prefix:
First Name:DAILIS
Middle Name:
Last Name:ESTEVEZ ARCIA
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 N BROADWELL AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4650
Mailing Address - Country:US
Mailing Address - Phone:308-267-8109
Mailing Address - Fax:
Practice Address - Street 1:515 N BROADWELL AVE
Practice Address - Street 2:
Practice Address - City:GRANS ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68003
Practice Address - Country:US
Practice Address - Phone:308-267-8109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty