Provider Demographics
NPI:1285434456
Name:MIZER, EDEN
Entity type:Individual
Prefix:
First Name:EDEN
Middle Name:
Last Name:MIZER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3854 SEWARD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-4043
Mailing Address - Country:US
Mailing Address - Phone:402-706-8247
Mailing Address - Fax:
Practice Address - Street 1:6305 AMES AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-2027
Practice Address - Country:US
Practice Address - Phone:888-226-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide