Provider Demographics
NPI:1043025497
Name:GAUSE, ERNEST D
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:D
Last Name:GAUSE
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 1:6489 WINTER HAZEL DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-8351
Mailing Address - Country:US
Mailing Address - Phone:317-250-3078
Mailing Address - Fax:
Practice Address - Street 1:5044 EVANS ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-3661
Practice Address - Country:US
Practice Address - Phone:317-250-3078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion