Healthcare Provider Details

I. General information

NPI: 1588463368
Provider Name (Legal Business Name): ADZOYO SIKA AYITE-ARTHUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4205 S 96TH ST
OMAHA NE
68127-1259
US

IV. Provider business mailing address

3804 S 191ST AVE
OMAHA NE
68130-4297
US

V. Phone/Fax

Practice location:
  • Phone: 531-466-1275
  • Fax: 531-242-4429
Mailing address:
  • Phone: 402-218-3787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number80151
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: