Healthcare Provider Details

I. General information

NPI: 1871319400
Provider Name (Legal Business Name): MUHAMMEDAMIN SADO WADO RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2024
Last Update Date: 02/09/2025
Certification Date: 02/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5460 W BRIXTON DR
LINCOLN NE
68521-5362
US

IV. Provider business mailing address

5460 W BRIXTON DR
LINCOLN NE
68521-5362
US

V. Phone/Fax

Practice location:
  • Phone: 206-664-1662
  • Fax:
Mailing address:
  • Phone: 206-664-1662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number93885
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: