Provider Demographics
NPI:1588463368
Name:AYITE-ARTHUR, ADZOYO SIKA
Entity type:Individual
Prefix:
First Name:ADZOYO
Middle Name:SIKA
Last Name:AYITE-ARTHUR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3804 S 191ST AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-4297
Mailing Address - Country:US
Mailing Address - Phone:402-218-3787
Mailing Address - Fax:
Practice Address - Street 1:4205 S 96TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1259
Practice Address - Country:US
Practice Address - Phone:531-466-1275
Practice Address - Fax:531-242-4429
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE80151163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty