Healthcare Provider Details

I. General information

NPI: 1679435267
Provider Name (Legal Business Name): MATTHEW BRADLEY AUSTIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6652 KARA DR
PAPILLION NE
68133-2109
US

IV. Provider business mailing address

6652 KARA DR
PAPILLION NE
68133-2109
US

V. Phone/Fax

Practice location:
  • Phone: 402-619-6414
  • Fax:
Mailing address:
  • Phone: 402-619-6414
  • 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: