Healthcare Provider Details

I. General information

NPI: 1801726187
Provider Name (Legal Business Name): AMYAH LEE MUTUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 E ST JOSEPH ST
SPALDING NE
68665-9791
US

IV. Provider business mailing address

211 E ST JOSEPH ST
SPALDING NE
68665-9791
US

V. Phone/Fax

Practice location:
  • Phone: 302-497-2419
  • Fax: 308-497-2419
Mailing address:
  • Phone: 308-497-2416
  • Fax: 308-497-2419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: