Healthcare Provider Details

I. General information

NPI: 1770389009
Provider Name (Legal Business Name): MARIA ZOE KUCERA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA KUCERA

II. Dates (important events)

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

III. Provider practice location address

2010 N 88TH ST
OMAHA NE
68134-6102
US

IV. Provider business mailing address

5321 S 138TH ST
OMAHA NE
68137-2913
US

V. Phone/Fax

Practice location:
  • Phone: 402-496-1000
  • Fax: 866-895-8250
Mailing address:
  • Phone: 402-895-4000
  • Fax: 866-895-8250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number89347
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: