Healthcare Provider Details

I. General information

NPI: 1427985282
Provider Name (Legal Business Name): RAMADHAN HAJI TALIB
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 TIERRA DR
LINCOLN NE
68516-5013
US

IV. Provider business mailing address

936 GARFIELD ST
LINCOLN NE
68502-2132
US

V. Phone/Fax

Practice location:
  • Phone: 402-601-8442
  • Fax: 402-601-8442
Mailing address:
  • Phone: 402-212-7113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: