Provider Demographics
NPI:1285449314
Name:MUSE, MARYAN ALI
Entity type:Individual
Prefix:
First Name:MARYAN
Middle Name:ALI
Last Name:MUSE
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 1:840 RIVERVIEW DR APT 10
Mailing Address - Street 2:
Mailing Address - City:SOUTH SIOUX CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68776-3576
Mailing Address - Country:US
Mailing Address - Phone:469-263-9654
Mailing Address - Fax:
Practice Address - Street 1:3900 DAKOTA AVE STE 9
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-3696
Practice Address - Country:US
Practice Address - Phone:402-518-2755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide