Healthcare Provider Details

I. General information

NPI: 1922962398
Provider Name (Legal Business Name): ALEXIS NEUGEBAUER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9804 NICHOLAS ST
OMAHA NE
68114-2161
US

IV. Provider business mailing address

9804 NICHOLAS ST
OMAHA NE
68114-2161
US

V. Phone/Fax

Practice location:
  • Phone: 515-225-4070
  • Fax:
Mailing address:
  • Phone: 515-225-4070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2766
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number2766
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: