Provider Demographics
NPI:1962201756
Name:TIDJANI, NAPELIS MISSI OLAWOLE
Entity type:Individual
Prefix:
First Name:NAPELIS MISSI
Middle Name:OLAWOLE
Last Name:TIDJANI
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 1:8903 N 161ST AVE
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68007-6417
Mailing Address - Country:US
Mailing Address - Phone:501-791-6086
Mailing Address - Fax:
Practice Address - Street 1:6550 S 84TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-4100
Practice Address - Country:US
Practice Address - Phone:501-791-6086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372500000X, 372600000X
NE86552163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion