Healthcare Provider Details

I. General information

NPI: 1639016868
Provider Name (Legal Business Name): ABDIRAHMAN ISSAK ABDI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 ARBOR ST STE 206
OMAHA NE
68124-2066
US

IV. Provider business mailing address

3019 NICHOLAS ST
OMAHA NE
68131-1445
US

V. Phone/Fax

Practice location:
  • Phone: 402-718-6900
  • Fax:
Mailing address:
  • Phone: 402-301-3401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: