Healthcare Provider Details

I. General information

NPI: 1548175532
Provider Name (Legal Business Name): WEEDOR FOBAY SAWO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 S ST APT 11
LINCOLN NE
68503-3047
US

IV. Provider business mailing address

2325 S ST APT 11
LINCOLN NE
68503-3047
US

V. Phone/Fax

Practice location:
  • Phone: 402-326-1568
  • Fax:
Mailing address:
  • Phone: 402-326-1568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License NumberH13280494
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: