Provider Demographics
NPI:1619778511
Name:THOAL, NYACHOCH PUOCH
Entity type:Individual
Prefix:
First Name:NYACHOCH
Middle Name:PUOCH
Last Name:THOAL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3216 EMMET ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-2817
Mailing Address - Country:US
Mailing Address - Phone:402-515-0210
Mailing Address - Fax:
Practice Address - Street 1:3216 EMMET ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-2817
Practice Address - Country:US
Practice Address - Phone:402-515-0210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide