Mick Thierry Bignoumba Mavioga
Individual provider Active NPI Home Health Aide · Elkhorn, NE
NPI 1023964780 · NPPES record last updated Mar 5, 2026
Key facts
- NPI
- 1023964780
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- Practice address
- 3404 N 187TH PLZ
Elkhorn, NE 68022-4302 - Phone
- (402) 686-1267
- NPI assigned
- Mar 5, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Yes |
Addresses
Primary practice location
3404 N 187TH PLZ
Elkhorn, NE 68022-4302
Mailing address
3404 N 187TH PLZ
Elkhorn, NE 68022-4302
Phone (402) 686-1267
Other providers in Elkhorn, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.