Healthcare Provider Details
I. General information
NPI: 1285432864
Provider Name (Legal Business Name): NYAKEK GACH BUOP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1820 HILLCREST DRIVE
BELLEVUE NE
68005
US
IV. Provider business mailing address
1923 WIRT ST
OMAHA NE
68110
US
V. Phone/Fax
- Phone: 402-682-6599
- Fax: 402-682-6593
- Phone: 402-612-4250
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: