Provider Demographics
NPI:1457144289
Name:LEON, MIRYAM
Entity type:Individual
Prefix:
First Name:MIRYAM
Middle Name:
Last Name:LEON
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 1:316 FRASIER ST
Mailing Address - Street 2:
Mailing Address - City:BEEMER
Mailing Address - State:NE
Mailing Address - Zip Code:68716-4272
Mailing Address - Country:US
Mailing Address - Phone:402-370-0247
Mailing Address - Fax:
Practice Address - Street 1:316 FRASIER ST
Practice Address - Street 2:
Practice Address - City:BEEMER
Practice Address - State:NE
Practice Address - Zip Code:68716-4272
Practice Address - Country:US
Practice Address - Phone:402-370-0247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-24
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker