Provider Demographics
NPI:1508566084
Name:NDIAYE, NANTENIN SR
Entity Type:Individual
Prefix:MRS
First Name:NANTENIN
Middle Name:
Last Name:NDIAYE
Suffix:SR
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7207 S 141ST ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-6240
Mailing Address - Country:US
Mailing Address - Phone:501-339-1434
Mailing Address - Fax:
Practice Address - Street 1:3710 FRANCES ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-3178
Practice Address - Country:US
Practice Address - Phone:402-669-0092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant