Provider Demographics
NPI:1003776212
Name:N'DA, KOUYEN'DOU
Entity type:Individual
Prefix:
First Name:KOUYEN'DOU
Middle Name:
Last Name:N'DA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5506 N 168TH AVE APT 419
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-3337
Mailing Address - Country:US
Mailing Address - Phone:531-222-7987
Mailing Address - Fax:
Practice Address - Street 1:4201 N 90TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-4136
Practice Address - Country:US
Practice Address - Phone:402-401-6689
Practice Address - Fax:402-939-0557
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty