Provider Demographics
NPI:1790211944
Name:AURE, CODY
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:AURE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:POTTER
Mailing Address - State:NE
Mailing Address - Zip Code:69156-0033
Mailing Address - Country:US
Mailing Address - Phone:308-250-0789
Mailing Address - Fax:
Practice Address - Street 1:404 CEDAR ST.
Practice Address - Street 2:
Practice Address - City:POTTER
Practice Address - State:NE
Practice Address - Zip Code:69156
Practice Address - Country:US
Practice Address - Phone:308-250-0789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program