Provider Demographics
NPI:1831998525
Name:GURUNG, INDRA MAYA (CAREGIVER)
Entity type:Individual
Prefix:
First Name:INDRA
Middle Name:MAYA
Last Name:GURUNG
Suffix:
Gender:
Credentials:CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3724 N 22ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68110-1719
Mailing Address - Country:US
Mailing Address - Phone:402-218-9719
Mailing Address - Fax:
Practice Address - Street 1:2020 MAPLE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68110-2115
Practice Address - Country:US
Practice Address - Phone:402-218-9719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion