Provider Demographics
NPI:1124896634
Name:HURKO, MIRZAMA
Entity type:Individual
Prefix:MRS
First Name:MIRZAMA
Middle Name:
Last Name:HURKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 W SUMNER CIR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68522-8730
Mailing Address - Country:US
Mailing Address - Phone:402-304-9495
Mailing Address - Fax:
Practice Address - Street 1:5000 W SUMNER CIR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68522-8730
Practice Address - Country:US
Practice Address - Phone:402-304-9495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
NE3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant