Provider Demographics
NPI:1033922158
Name:JUELAH, KHU KHU
Entity type:Individual
Prefix:
First Name:KHU KHU
Middle Name:
Last Name:JUELAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3817 N 85TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-4816
Mailing Address - Country:US
Mailing Address - Phone:336-343-8925
Mailing Address - Fax:
Practice Address - Street 1:3817 N 85TH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-4816
Practice Address - Country:US
Practice Address - Phone:336-343-8925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant