Healthcare Provider Details

I. General information

NPI: 1992641294
Provider Name (Legal Business Name): AUTUM BRABAW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20964 COUNTY RD 4
MORRILL NE
69358-3740
US

IV. Provider business mailing address

11011 Q ST STE 101C
OMAHA NE
68137-3700
US

V. Phone/Fax

Practice location:
  • Phone: 402-838-0211
  • Fax:
Mailing address:
  • Phone: 402-697-5121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: