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General NPI Number Information
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NPI Number | 1801753538
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Entity Type | Individual
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Provider Name | MIRIUM ROSE GOUIN
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Gender | Female
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 2350 N 92ND AVE APT 8
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City | OMAHA
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State | NE
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Zip | 68134-5942
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Country | US
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Telephone | 531-232-7143
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Fax |
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Provider Business Mailing Address
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Address Line | 2350 N 92ND AVE APT 8
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City | OMAHA
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State | NE
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Zip | 68134-5942
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Country | US
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Telephone | 531-232-7143
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number | 193400000X
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License Number State | NE
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