Provider Demographics
NPI:1992502777
Name:EDORH, AHOUEFA HEMEADE
Entity type:Individual
Prefix:
First Name:AHOUEFA
Middle Name:HEMEADE
Last Name:EDORH
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 1:11030 Q ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-3742
Mailing Address - Country:US
Mailing Address - Phone:240-899-1188
Mailing Address - Fax:
Practice Address - Street 1:11030 Q ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3742
Practice Address - Country:US
Practice Address - Phone:402-932-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide