MEDICARE: MISSERY LEON HARUO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372500000X	Chore Provider

General Provider Information

NPI Number	:	1104781194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISSERY LEON HARUO

Provider Business Mailing Address
First Line	:	821 AVENUE J
Second Line	:
City	:	COZAD
State	:	NE
Zip	:	69130-1708
Country	:	US
Telephone Number	:	308-784-4222
Fax Number	:	308-784-4222

Provider Business Practice Location Address
First Line	:	1212 N JACKSON ST
Second Line	:
City	:	LEXINGTON
State	:	NE
Zip	:	68850-1731
Country	:	US
Telephone Number	:	308-784-4222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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Directions to “ MISSERY LEON HARUO ” Practice Location

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