Provider Demographics
NPI:1932908407
Name:GOEKEN, AMY MARIE
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:GOEKEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:CLAUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 S BIRCHWOOD DRIVE
Mailing Address - Street 2:APT D
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025
Mailing Address - Country:US
Mailing Address - Phone:402-919-4836
Mailing Address - Fax:
Practice Address - Street 1:401 S BIRCHWOOD DRIVE
Practice Address - Street 2:APT D
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025
Practice Address - Country:US
Practice Address - Phone:402-919-4836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist