Healthcare Provider Details

I. General information

NPI: 1598695025
Provider Name (Legal Business Name): BURAE ADAM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 N 49TH ST APT 143
OMAHA NE
68132-1641
US

IV. Provider business mailing address

1503 N 48TH ST APT 12
OMAHA NE
68104-5152
US

V. Phone/Fax

Practice location:
  • Phone: 402-578-1802
  • Fax:
Mailing address:
  • Phone: 402-578-1802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: