Healthcare Provider Details

I. General information

NPI: 1639009772
Provider Name (Legal Business Name): MAHAD ABDIQADIR ADEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: NASIR OSMAN BURHAN

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 PARK ST APT 2
LEXINGTON NE
68850-1254
US

IV. Provider business mailing address

1403 PARK ST APT 2
LEXINGTON NE
68850-1254
US

V. Phone/Fax

Practice location:
  • Phone: 111-111-1111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: