Healthcare Provider Details

I. General information

NPI: 1447177845
Provider Name (Legal Business Name): NEVAEH MASON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10828 OLD MILL RD
OMAHA NE
68154-2647
US

IV. Provider business mailing address

10828 OLD MILL RD
OMAHA NE
68154-2647
US

V. Phone/Fax

Practice location:
  • Phone: 402-504-3219
  • Fax:
Mailing address:
  • Phone: 402-504-3219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License NumberH14235083
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: