Healthcare Provider Details

I. General information

NPI: 1023948718
Provider Name (Legal Business Name): KOSSI KPATINDE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2816 N 192ND CT APT 1B
ELKHORN NE
68022-2650
US

IV. Provider business mailing address

2816 N 192ND CT APT 1B
ELKHORN NE
68022-2650
US

V. Phone/Fax

Practice location:
  • Phone: 515-147-5561
  • Fax:
Mailing address:
  • Phone: 531-999-1133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: