Provider Demographics
NPI:1487188538
Name:ADOUKONOU, SENAME O (RN)
Entity Type:Individual
Prefix:MR
First Name:SENAME
Middle Name:O
Last Name:ADOUKONOU
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 N 169TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-2689
Mailing Address - Country:US
Mailing Address - Phone:402-896-9988
Mailing Address - Fax:402-932-4854
Practice Address - Street 1:10011 J ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1106
Practice Address - Country:US
Practice Address - Phone:402-896-9988
Practice Address - Fax:402-932-4854
Is Sole Proprietor?:No
Enumeration Date:2017-04-16
Last Update Date:2017-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE77328163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse