MEDICARE: CORA NAIBERK OT

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	225X00000X	Occupational Therapist	3037	NE

General Provider Information

NPI Number	:	1730062217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORA NAIBERK OT

Provider Business Mailing Address
First Line	:	3454 INNATE LN APT 102
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68803-5541
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3454 INNATE LN
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68803-5538
Country	:	US
Telephone Number	:	402-641-0381
Fax Number	:

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

Provider Enumeration Date	:	07/30/2025
Last Update Date	:	05/28/2026

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