Provider Demographics
NPI:1992519334
Name:BIOBOU, AXEL
Entity type:Individual
Prefix:
First Name:AXEL
Middle Name:
Last Name:BIOBOU
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 1:204 GALVIN RD N
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-4899
Mailing Address - Country:US
Mailing Address - Phone:531-232-5040
Mailing Address - Fax:
Practice Address - Street 1:3108 JASON CIR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-2286
Practice Address - Country:US
Practice Address - Phone:862-899-6355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist