Provider Demographics
NPI:1710876594
Name:SIMET, JUSTIN THOMAS
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:THOMAS
Last Name:SIMET
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 1:4611 S 96TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1202
Mailing Address - Country:US
Mailing Address - Phone:402-987-8059
Mailing Address - Fax:
Practice Address - Street 1:4611 S 96TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1202
Practice Address - Country:US
Practice Address - Phone:402-987-8059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-28
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider