Healthcare Provider Details

I. General information

NPI: 1952291213
Provider Name (Legal Business Name): DAVID JAMES MIZE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8790 F ST STE 124
OMAHA NE
68127-1529
US

IV. Provider business mailing address

8790 F ST STE 124
OMAHA NE
68127-1529
US

V. Phone/Fax

Practice location:
  • Phone: 402-316-7191
  • Fax:
Mailing address:
  • Phone: 402-316-7191
  • 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: