Healthcare Provider Details

I. General information

NPI: 1487450730
Provider Name (Legal Business Name): ERIK MASHEK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2025
Last Update Date: 02/19/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 SWEETWATER AVE
ALLIANCE NE
69301-2672
US

IV. Provider business mailing address

C21 MEADOWS CT
ALLIANCE NE
69301-4338
US

V. Phone/Fax

Practice location:
  • Phone: 308-762-4331
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: