Provider Demographics
NPI:1336946185
Name:COOPER HOSKINS, KADGA LYNN
Entity type:Individual
Prefix:
First Name:KADGA
Middle Name:LYNN
Last Name:COOPER HOSKINS
Suffix:
Gender:
Credentials:
Other - Prefix:MRS
Other - First Name:KADGA
Other - Middle Name:LYNN
Other - Last Name:STENNIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3341 N 103RD PLAZA
Mailing Address - Street 2:20
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134
Mailing Address - Country:US
Mailing Address - Phone:402-301-6277
Mailing Address - Fax:
Practice Address - Street 1:1820 HILLCREST DRIVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005
Practice Address - Country:US
Practice Address - Phone:402-682-6599
Practice Address - Fax:402-682-6563
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant