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General NPI Number Information
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NPI Number | 1003776212
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Entity Type | Individual
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Provider Name | KOUYEN'DOU N'DA
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Gender | Male
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Dates
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Enumeration Date | 11/12/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 4201 N 90TH ST
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City | OMAHA
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State | NE
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Zip | 68134-4136
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Country | US
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Telephone | 402-401-6689
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Fax | 402-939-0557
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Provider Business Mailing Address
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Address Line | 5506 N 168TH AVE APT 419
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City | OMAHA
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State | NE
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Zip | 68116-3337
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Country | US
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Telephone | 531-222-7987
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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