Healthcare Provider Details

I. General information

NPI: 1922915073
Provider Name (Legal Business Name): AIRA GOETZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2614 W 42ND ST
SCOTTSBLUFF NE
69361-4802
US

IV. Provider business mailing address

1606 AVENUE I
SCOTTSBLUFF NE
69361-2961
US

V. Phone/Fax

Practice location:
  • Phone: 308-630-0600
  • Fax:
Mailing address:
  • Phone: 308-632-8016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: